TMS and Medicare
Many patients ask if Medicare will pay for TMS (Transcranial magnetic stimulation). The answer is yes. Medicare will pay for TMS as long as the patient meets the following criteria:
#1 – Has a diagnosis of severe major depressive disorder
#2 – AND did not have a clinically significant response to a single trial of an antidepressant OR was unable to tolerate 2 different agents from 2 different classes
#3 – A trial of evidence-based psychotherapy known to be effective in the treatment of major depressive disorder was attempted without significant improvement.
If these three criteria are met, then Medicare will pay for TMS. A prior authorization is not required if the criteria are met. The first treatment (the mapping of the patient to find the dorsolateral prefrontal cortex AKA “the depression center of the brain”) is performed by a psychiatrist. All other treatments can be done by a TMS technician under the supervision of the psychiatrist. However, currently at Front Range TMS, Dr. Clint Tanner, MD will perform all treatments of TMS. He will personally verify that each treatment is correctly positioned to give treatment to the depression center of the brain.
If you have and other questions about TMS and Medicare, you can contact us here or go to the contact us page in our website, and we would be happy to answer your questions. We hope that you found our article helpful.