Insurance

BrainsWay’s Deep TMS treatment for MDD is covered by most insurance companies and HMOs in the United States.  OCD coverage may currently be available on a single case agreement basis.

Search Results

Search Results

Search Results

Search Results

Sharp Health Plan

Sharp Health Plan

Click here for more info >
Valley Health Plan

Valley Health Plan

Click here for more info >
Western Health Advantage

Western Health Advantage

Click here for more info >

Search Results

Search Results

Search Results

Highmark BCBS of Delaware

Highmark BCBS of Delaware

Click here for more info >

Search Results

Capital Health Plan

Capital Health Plan

Click here for more info >
Florida Health Care Plan

Florida Health Care Plan

Click here for more info >

Health Options (BCBS of FL)

Click here for more info >

Search Results

Search Results

United Healthcare

United Healthcare

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Hawaii Medical Service Association

Hawaii Medical Service Association

Click here for more info >
Kaiser Permanente

Kaiser Permanente

Click here for more info >

Search Results

Regence

Regence BlueSheild of Idaho

Click here for more info >
SelectHealth, Inc.

SelectHealth, Inc.

Click here for more info >

Search Results

Health Alliance Midwest

Health Alliance Medical Plans

Click here for more info >
Medical Associates Health Plan

Medical Associates Health Plan

Click here for more info >
Union Health Service

Union Health Service

Click here for more info >

Search Results

Indiana University Health Plans

Indiana University Health Plans

Click here for more info >

Search Results

Gundersen Health Plan

Click here for more info >
Health Alliance Midwest

Health Alliance Midwest

Click here for more info >

Health Partners Administrators

Click here for more info >

Medica Insurance Company

Click here for more info >
Medical Associates Health Plan

Medical Associates Health Plan

Click here for more info >
Sanford Health Plan

Sanford Health Plan

Click here for more info >

Wellmark Health Plan

Click here for more info >

Search Results

Coventry

Coventry Health Care of Kansas

Click here for more info >

Search Results

Search Results

CHRISTUS Health Plan

CHRISTUS Health Plan

Click here for more info >
Vantage Health Plan

Vantage Health Plan

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Harvard Pilgrim

Harvard Pilgrim

Click here for more info >

Maine Community Health Options

Click here for more info >

Martin’s Point US Family Health Plan

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Evergreen Health Cooperative

Evergreen Health Cooperative

Click here for more info >
Johns Hopkins US Family Health Plan

Johns Hopkins US Family Health Plan

Click here for more info >
Kaiser Permanente

Kaiser Permanente

Click here for more info >

Search Results

BCBS of Massachusetts

BCBS of Massachusetts

Click here for more info >

Fallon Community Health Plan

Click here for more info >
Harvard Pilgrim

Harvard Pilgrim

Click here for more info >

Martin’s Point US Family Health Plan

Click here for more info >

Minuteman Health, Inc

Click here for more info >
Neighborhood Health Plan

Neighborhood Health Plan

Click here for more info >
Tufts Associated Health Maintenance Org

Tufts Associated Health Maintenance Org

Click here for more info >

Search Results

Health Alliance Plan of Michigan

Health Alliance Plan of Michigan

Click here for more info >
McLaren Health Plan Community

McLaren Health Plan Community

Click here for more info >
Physicians Health Plan

Physicians Health Plan

Click here for more info >
Priority Health

Priority Health

Click here for more info >
Total Health Care USA

Total Health Care USA

Click here for more info >

Search Results

PreferredOne Community Health Plan

Click here for more info >

Search Results

BCBS of Mississippi

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

UnitedHealthcare Military & Veterans Services

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Health Alliance Midwest

Health Alliance Midwest

Click here for more info >

Search Results

Anthem of VA

Anthem of Nevada

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Health Plan of Nevada

Health Plan of Nevada

Click here for more info >
Prominence Health Plan

Prominence Health Plan

Click here for more info >

United Healthcare of Nevada

Click here for more info >

Search Results

Anthem of VA

Anthem of New Hampshire

Click here for more info >
Harvard Pilgrim

Harvard Pilgrim

Click here for more info >

Martin’s Point US Family Health Plan

Click here for more info >

Minuteman Health, Inc

Click here for more info >
Tufts Associated Health Maintenance Org

Tufts Associated Health Maintenance Org

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

BCBS New Mexico

BCBS New Mexico

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
New Mexico Health Connections

New Mexico Health Connections

Click here for more info >

Search Results

Capital District Physicians’ Health Plan

Click here for more info >

Empire Health Choice

Click here for more info >
HealthNow New York

HealthNow New York

Click here for more info >
HIP Health Plan of NY

HIP Health Plan of NY

Click here for more info >

Independent Health Association

Click here for more info >

Martin’s Point US Family Health Plan

Click here for more info >

MVP Health Plan

Click here for more info >

Univera Healthcare

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

United Healthcare

United Healthcare

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

Community Insurance Co. BCBS of OH

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Consumers Life Insurance

Click here for more info >
HealthSpan Integrated Care

HealthSpan Integrated Care

Click here for more info >

Medical Mutual of Ohio

Click here for more info >
Paramount Insurance Co.

Paramount Insurance Co.

Click here for more info >
Summa Insurance Co.

Summa Insurance Co.

Click here for more info >
The Health Plan of Upper Ohio Valley

The Health Plan of Upper Ohio Valley

Click here for more info >

Search Results

United Healthcare

United Healthcare

Click here for more info >
Community Care Managed Healthcare

Community Care Managed Healthcare

Click here for more info >
Global Health Inc.

Global Health Inc.

Click here for more info >

Search Results

Community Care Managed Healthcare

Community Care Managed Healthcare

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Moda Health Plan

Moda Health Plan

Click here for more info >
Providence

Providence of Oregon

Click here for more info >
Regence

Regence BCBS of Oregon

Click here for more info >

Search Results

HMO of Northeastern PA

Highmark BCBS of PA

Click here for more info >
HMO of Northeastern PA

HMO of Northeastern PA

Click here for more info >
Independence Hospital Indemnity

Independence Hospital Indemnity

Click here for more info >
UPMC Benefit Management

UPMC Benefit Management

Click here for more info >

Search Results

Search Results

Brighton Marine US Family

Brighton Marine US Family

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

Avera Health Plan

Avera Health Plan

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Search Results

Community First Health Plan

Community First Health Plan

Click here for more info >
Oscar Insurance Co. of TX

Oscar Insurance Co. of TX

Click here for more info >
Scott and White Health Plan

Scott and White Health Plan

Click here for more info >
SHA, LLC dba Firstcare

SHA, LLC dba Firstcare

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Regence

Regence BCBS of Utah

Click here for more info >
SelectHealth, Inc.

SelectHealth, Inc.

Click here for more info >
University of Utah Health Plan

University of Utah Health Plan

Click here for more info >

Search Results

Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >

Martin’s Point US Family Health Plan

Click here for more info >

Search Results

Innovation Health Insurance

Innovation Health Insurance

Click here for more info >
Optima Health Plan

Optima Health Plan

Click here for more info >

Search Results

Lifewise health plan of Washington

Lifewise health plan of Washington

Click here for more info >
United Healthcare

United Healthcare

Click here for more info >

Asuris Northwest Health

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Providence

Providence Health Plans

Click here for more info >

Search Results

Search Results

The Health Plan of Upper Ohio Valley

The Health Plan of Upper Ohio Valley

Click here for more info >

Search Results

Dean Health Plan

Dean Health Plan

Click here for more info >
Group Health Cooperative of South Central Wisconsin

Group Health Cooperative of South Central Wisconsin

Click here for more info >

Gundersen Health Plan

Click here for more info >

Health Partners Administrators

Click here for more info >
Medical Associates Health Plan

Medical Associates Health Plan

Click here for more info >
MercyCare Health Plans

MercyCare Health Plans

Click here for more info >
Network Health Plan

Network Health Plan

Click here for more info >
Security Health Plan Of Wisconsin

Security Health Plan Of Wisconsin

Click here for more info >

Unity Health Plans

Click here for more info >
BrainsWay accepts Arise Health Plan

WPS Health Plan

Click here for more info >

Search Results

United Healthcare

United Healthcare

Click here for more info >
Compass Rose Health Plan

Compass Rose Health Plan

Click here for more info >
Deep TMS Coverage Basics

On the strength of FDA-clearance, peer-reviewed clinical evidence, and real-life clinical success, many public and private insurance carriers now offer coverage for Deep TMS.

Coverage differs by country, state, and insurance plan – if you are considering treatment, please speak to your healthcare provider and/or insurance carrier for additional information on coverage.

In the US, which is characterized by public payors, such as Medicare, Medicaid, and Tricare, and private payors, such as Aetna, Cigna, and United Healthcare, prior authorization is typically required to authorize TMS treatment.  Healthcare providers offering Deep TMS should become credentialed with the insurance carrier.  Out-of-network providers, or those seeking patient coverage for non-covered TMS treatment, can seek single case agreements.

In Canada, which is characterized by a universal public healthcare system administered by provincial health ministries and supplementary private policies, insurance coverage differs among provinces.

Beyond North America, BrainsWay Deep TMS treatment is covered throughout Europe, Asia, and other regions, as an increasing number of insurance providers are looking to meet their clients’ needs by offering coverage for this groundbreaking treatment.

Patient costs for TMS treatment can involve copays per session or co-insurance, taking into account deductibles and out-of-pocket maximums.

Insurance carriers’ medical policies and criteria for authorizing Deep TMS treatment vary, but will generally include several requirements, including primary diagnosis of Major Depressive Disorder and sufficient antidepressant and psychotherapy trials which had insufficient outcomes or intolerable side effects document in recognized ratings scales.  As the number and duration of trials required differ, we encourage you to consult directly with insurers or reach out to BrainsWay’s reimbursement support team for assistance.

3 Distinct CPT Codes have been created by the AMA for TMS treatment:

  • 90867 – initial TMS session that includes motor threshold determination, mapping, and the first treatment session.
  • 90868 – individual subsequent treatment sessions
  • 90869 – any subsequent session that includes a motor threshold redetermination

Additional information on coding can be found in the resources below.

BrainsWay’s Reimbursement Center

BrainsWay offers reimbursement support services for your practice as it seeks to provide optimal care to your MDD & OCD patients who are eligible for TMS treatment.

BrainsWay established “Reimbursement on Demand” as a means of providing guidance and support to our partners in navigating the sometimes complex reimbursement process in different states with different payers. We have reimbursement experts on staff who can provide hands-on assistance to help ensure the success of our clinical partners.

Services include:

  • Benefits verification
  • Medical exception support services
  • Guidance with prior authorizations (PA) and follow up
  • Guidance with pre-determinations (Pre-D) and follow up
  • Assistance with claim submissions
  • Appeals support

Contact our reimbursement support team at:
  • Phone:  844-333-7867 (844 DEEP TMS)
  • Fax:  844-332-3897
  • Email:  info@BrainsWayReimb.com

*NOTE : BrainsWay provides its reimbursement support, service and any related information for your convenience only. These services and all related information are not recommendations regarding clinical practice, and are generalized in nature. This generalized guidance is meant to guide – not replace – the reimbursement and billing staff of the doctor/clinic. BrainsWay does not make any representations or warranties regarding payment, and there are no guarantees of payment by any payer. It is the absolute and sole responsibility of the provider to ensure that a medical necessity determination is reached, and that appropriate claims and charges for services rendered are submitted. In the event that a favorable coverage determination is not achieved, BrainsWay is not and shall not be liable for any cost whatsoever, including those related to the patient’s medical treatment.


 

Download Reimbursement Resources