Transcranial magnetic stimulation (TMS) is a non-invasive and effective therapy for several types of mood disorders. It is often used for treatment-resistant depression after several trials of antidepressant medications have not effectively reduced your symptoms.
But how much does TMS therapy cost? The cost depends on several factors, including your insurance coverage. If you are seeking relief from treatment-resistant depression symptoms, call us today to schedule a consultation for TMS therapy. We could explain our process for TMS therapy and estimate how much it would cost with your insurance coverage.
Several factors impact the cost of your TMS therapy sessions, including the condition for which you are being treated, the severity of your symptoms, and how quickly you respond to the therapy. The average person who receives TMS therapy at our office undergoes sessions that are roughly five minutes long, which means they spend less than 15 minutes in our office.
TMS requires a treatment cycle of five treatment sessions per week over approximately nine weeks. However, in some instances, your symptoms may begin to resolve more quickly or more slowly than anticipated, which means you may receive treatment for slightly less or more than nine weeks. This can affect the overall cost of your therapy.
Another factor that affects the cost of TMS therapy is insurance coverage. Federal law mandates that most insurance providers offer the same level of benefits for mental health treatments that they provide for medical and surgical care. However, not all insurance providers recognize TMS therapy, and your coverage details determine how much of the cost your policy covers.
These details include:
Each of these factors can influence your out-of-pocket expenses once your insurance policy has paid benefits.
Insurance companies decide benefits based on medical necessity, and their decisions could affect the cost of your TMS treatments. Medical necessity is an insurance term that means the treatment you are receiving is medically necessary to adequately and effectively address your symptoms.
In 2008, the FDA approved TMS therapy for treatment-resistant depression. Since then, the FDA has approved TMS treatments for various other mental health conditions. To meet medical necessity guidelines for TMS therapy, you must have a diagnosed mental health condition that the FDA has approved for treatment. Typically, this includes major depressive disorder.
Some insurance plans may also offer coverage for TMS as an adjunct therapy for obsessive-compulsive disorder, post-traumatic stress disorder, or anxiety disorders. Generally, your condition must have failed to respond to at least two antidepressant medications that were prescribed at the correct dosage and that you took over an adequate time period. Most insurance companies require you to have completed an adequate amount of psychotherapy without significant improvement in your mental health.
Finally, there must be no contraindications to using TMS therapy. If you have any implanted metal devices, such as a cochlear implant, pacemaker, or deep brain stimulator, the electromagnetic pulses could affect their function. If you have a known history of seizures, epilepsy, or other history of severe neurological conditions, you may not be a good candidate for TMS therapy.
Since insurance companies use medical necessity to determine whether they will offer benefits for TMS treatment, you may need to submit documentation for prior authorization. This is an important step in determining your TMS therapy’s cost because even if your insurance company covers TMS treatments, they will not pay for them if you do not obtain prior authorization.
Prior authorization for TMS therapy typically includes documentation about the antidepressant medications you have taken and their effectiveness. Your insurance provider may ask you or the prescribing physicians for this documentation.
TMS therapy has proven to be highly effective with very few side effects for people with treatment-resistant depression or as an adjunct therapy for several other mental health conditions. If you are considering treatment options for depression or other conditions and would like to ask a medical professional, “How much does TMS therapy cost?”, speak with us today to schedule an appointment. Our caring team would be happy to tell you all about TMS therapy and explain how much it may cost for your health condition and with your insurance coverage.
