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Insurance Coverage for TMS Therapy

Most major insurance providers now cover TMS therapy for patients with treatment-resistant depression and certain other mental health conditions. At Advanced TMS Clinic, our team works directly with your insurance provider to verify eligibility and help you understand your coverage before treatment begins.

Our goal is to make advanced mental health care accessible by guiding you through insurance verification, treatment eligibility, and financing options.

Is TMS Covered by Insurance?

Most major insurance companies cover TMS therapy when specific medical criteria are met. Coverage typically applies to patients diagnosed with moderate to severe depression who have not experienced sufficient improvement with traditional medications.

You may qualify if:

These requirements vary by insurance provider, and our team helps verify eligibility before starting treatment.

Insurance Providers We Work With

Advanced TMS Clinic works with many major insurance providers to help patients access TMS therapy.

Common providers include:

Each insurance company has its own approval criteria, and our team can help determine your eligibility.

Special Coverage for Military & Veterans

Advanced TMS Clinic proudly supports active-duty military members, veterans, and their families.

We are an in-network provider for TRICARE West, helping military families access advanced depression treatment when traditional therapies have not worked.

Through partnerships with TriWest and the Veterans Affairs Community Care Program, eligible veterans can also receive TMS therapy through their VA benefits.

TRICARE

TriWest

VA Coverage

Who may qualify

How Much Does TMS Treatment Cost?

Covered by Insurance

Most major insurers cover TMS for depression, including Aetna, Cigna, Optum, Tricare, Anthem/Blue Cross Blue Shield, Medicare, Medi-Cal, and more.

Accelerated One-Day TMS – $6,250

Includes:

Accelerated SAINT-Inspired Treatment

Includes:

How Much Does TMS Treatment Cost?

The cost of TMS therapy varies depending on insurance coverage and treatment needs.

Without Insurance

A full course of TMS therapy typically ranges between $6,000 – $12,000 depending on the number of sessions required.

With Insurance

Most patients pay significantly less when insurance covers treatment.

Typical patient costs may include:

Our team verifies your insurance benefits before treatment begins so you understand your expected costs.

Financing Options

For patients whose treatment is not fully covered by insurance, Advanced TMS Clinic offers financing options to make care more accessible. Financing may be available through:

These programs help patients manage treatment costs through flexible monthly payment options.

How to Get Started

Step 1
Clinical Consultation

Schedule a free 10 min consultation with our team to determine if TMS is the right treatment for you.

Step 2
Verification of Benefits

Contact us to review and verify your insurance coverage options for TMS therapy.

Step 3
Personalized Treatment Plan

After that, we will develop a personalized treatment plan tailored to your needs.

Frequently Asked Questions

Have questions about TMS therapy? Here are answers to some of the most common concerns from our patients.

Is TMS therapy covered by insurance?

Most major insurance providers cover TMS therapy for patients diagnosed with major depressive disorder, especially when medication has not been effective. Our team will verify your benefits and guide you through the approval process.

TMS is generally well tolerated. Patients may feel a light tapping sensation on the scalp during treatment, but it is not considered painful. No anesthesia or sedation is required.

A typical session lasts as short as 3 min with Theta(iTBS) therapy and up to 20mins (18.5 mins) for standard therapy on avg. You can drive yourself to and from appointments and return to your day right after.

A standard treatment course usually involves sessions five days a week for several weeks. Your personalized treatment plan will be determined during your consultation.

Most side effects are mild and temporary, such as slight scalp discomfort or headache. Unlike medications, TMS does not cause systemic side effects like weight gain, fatigue, or sexual dysfunction.

TMS is often recommended for individuals who have not experienced sufficient improvement with antidepressant medications. A clinical evaluation will help determine if TMS is right for you.

Commercial Insurance Providers

Aetna
  • Requires failure of 2 Antidepressants from different classes
  • Requires failure of an augmentation strategy (combination of 2 medications)
    • OR Documented Medication side effect reaction/introlerance
Anthem BC
  • Requires failure of 2 antidepressants from different classes
  • Alternatively, intolerance to medications with documented side effects
Beacon Health Options
  • Requires failure of 2 antidepressants from different classes
  • Alternatively, intolerance to 4 medications with documented side effects
Cigna/Evernorth
  • Requires failure of 2 antidepressants from different classes
  • Adequate trial of psychotherapy
Medicaid

We are currently in contract with Optum Behavorial Health of San Diego

  • Requires failure of 2 antidepressants from different classes
  • Diagnosis of Severe Depression
Medicare
  • Requires failure of a single antidepressant or intolerance to 2 antidepressants from separate classes
  • Adequate trial of psychotherapy
Magellan/Sharp/BS of CA/Scripps Health Plan
  • Requires failure of 2 antidepressants from different classes
  • Same criteria applies to medication intolerance
  • Adequate trial of psychotherapy
Tricare West
  • Covered for Major Depression when medically necessary and less intensive treatments have failed
  • Requires 1 Antidepressant failure or intolerance to 2 medications from separate classes
    • OR trial of psychotherapy
Optum/United Behavioral Health
  • Requires failure of 2 antidepressants from different classes
  • Same criteria applies to medication intolerance
  • Adequate trial or psychotherapy

TRICARE West

TRICARE West is a division of TRICARE that covers western regions of the U.S. These regions include:

Advanced TMS currently does not accept Tricare East, managed by Humana. If you recently moved to San Diego County and are looking to switch to the Tricare West region, please contact their customer service at (888) 874-9378 This number will assist you with any changes or inquiries related to your Tricare coverage when moving between these regions.

Is TMS Therapy Right For Me?

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