Is Deep TMS covered by insurers?

These days, the stigma around treating mental health is thankfully being eroded in society, and insurance providers are catching up by offering clients a broader range of mental health therapies covered by their plans. Deep Transcranial Magnetic Stimulation (or dTMS) is one such therapy that has been improving the lives of many patients suffering from challenging mental health conditions, such as depression and OCD.

Deep TMS offers a complement to common mental health treatments such as psychotherapy and psychiatric medication, which do not always manage to alleviate mental health symptoms and can present significant side effects. Looking for another effective treatment course that safely addresses patient needs, an increasing number of insurance providers now cover Deep TMS for depression, as a well-studied, clinically proven method with no systematic side effects that can help their clients in the battle for greater mental health. dTMS has been FDA cleared since 2013 for the treatment of depressive episodes in adult patients suffering from Major Depressive Disorder, who failed to achieve satisfactory improvement from previous antidepressant medication treatment in the current episode. (FDA 510(k) No. K122288)

More recently, dTMS has been FDA cleared since 2018 as an intended adjunct treatment for adult patients suffering from Obsessive-Compulsive Disorder. (FDA De Novo No. DEN 170078). Insurance companies are currently reviewing clinical data in order to determine how to cover Deep TMS treatment for OCD.

In order to be eligible for Deep TMS treatment coverage, an individual with a mental health condition must meet the requirements defined by their insurance provider, which are informed by the specific local standards and guidelines.

Transcranial Magnetic Stimulation cost

dTMS Insurance Coverage Options

Where covered by their insurance, patients will typically incur the co-pay or co-insurance per treatment session that is specified in their insurance plan.

Patients whose insurance plan does not specify dTMS coverage should speak with their mental health provider regarding payment options, since in some cases single-case agreements can be reached with insurance providers to cover Transcranial Magnetic Stimulation costs.

BrainsWay provides consulting support to providers of Deep TMS to assist with navigating the insurance coverage landscape.

In addition to the U.S., BrainsWay’s dTMS treatment is also covered throughout Europe and other regions as a viable treatment option for additional mental health conditions, including PTSD, Parkinson’s disease, bipolar disorder and more. As a growing body of research reaffirms the benefits dTMS can offer in a variety of mental health conditions, more and more insurance providers are offering coverage and copayment plans that address additional mental health disorders, in an effort to suit their clients’ needs.

At present, dTMS is more readily available—and covered by insurance—than ever before, resulting in more payment plans for those who might benefit from it.