What is the Cost of TMS Therapy?
When considering the pros and cons of utilizing a medical treatment for major depressive disorder (MDD), the costs are an important consideration.
With regard to TMS therapy for MDD, one must consider not only the financial costs to obtain this important breakthrough treatment, but also what it costs to not receive treatment for the debilitating effects of medication-resistant depression.
Insurance and TMS
Thankfully, insurance companies are starting to understand the cost-effectiveness of TMS when looking at the big picture of a member who continues to trial, unsuccessfully, one antidepressant after another. While the depression symptoms worsen, other complications, such as acquiring a substance use disorder, can compound the medical costs of untreated Major Depressive Disorder (MDD). Considering the collateral effects of untreated MDD, providers are now offering coverage for TMS therapy when certain criteria are met. These criteria include:
- A qualifying medical diagnosis (treatment is medically necessary)
- Failure of patient to respond to usual antidepressant medication
- Patient had received some psychotherapy
Although these are the general criteria required for authorizing TMS benefits, each insurance carrier, as well as the various healthcare plans, can vary with regard to the specific qualifying criteria.
PHQ-9 Depression Screening
Anew Era TMS & Psychiatry offers an online version of the commonly used Depression Screening tool called the PHQ-9. The nine items of the PHQ-9 are based directly on the nine diagnostic criteria for major depressive disorder in the DSM-IV.
Insurance Providers that Cover TMS Therapy for MDD
Presently, 273 million patients have insurance policies that cover TMS therapy to some degree in their health plans. TRICARE, insurance provider for the military, now offers coverage for TMS treatments for veterans who suffer from PTSD and MDD. The other insurers that offer some degree of coverage for TMS are:
California TMS Health Insurance Coverage
- Aetna
- Blue Shield of California
- Cigna
- Anthem Blue Cross
- Magellan
- Tri-Care
- United Health Care
- Chipa
- Optum
- Health Net
United States TMS Health Insurance Coverage
- Anthem Blue Cross and Blue Shield
- Arkansas Blue Cross Blue Shield
- Blue Cross Blue Shield of Alabama
- Blue Cross Blue Shield of Arizona
- Blue Cross Blue Shield of Florida
- Blue Cross Blue Shield of Hawaii (HMSA – Hawaii Medical Services Association)
- Blue Cross Blue Shield of Kansas
- Blue Cross Blue Shield of Louisiana
- Blue Cross Blue Shield of Massachusetts
- Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan
- Blue Cross Blue Shield of Minnesota
- Blue Cross Blue Shield of Nebraska
- Blue Cross Blue Shield of North Carolina
- Blue Cross Blue Shield of Rhode Island
- Blue Cross Blue Shield of Tennessee
- Blue Cross Blue Shield of Vermont
- Blue Cross Blue Shield of Western New York (Under Health Now)
- Blue Cross Blue Shield Federal Employee Program
- Blue Cross of Idaho
- Blue Shield of California
- Blue Shield of Northeastern New York (Under Health Now)
- Capital Blue Cross
- Cigna
- Community Care of Oklahoma
- Emblem Health
- Harvard Pilgrim
- Health Care Service Corporation (HCSC) for BCBS of Illinois, Montana, New Mexico, Oklahoma, and Texas
- Health Net
- Health New England
- Horizon Blue Cross Blue Shield of New Jersey
- Independence Blue Cross
- Independent Health Association
- MVP Healthcare
- Optima Behavioral Health
- Oxford Health Plans
- Premera Blue Cross
- Priority Health
- Public Employees Insurance Agency (PEIA)
- The Regence Group
- Tri-Care
- Tufts Health Plan
- United Healthcare/OPTUM by United Behavioral Health
Government Plan Coverage
MEDICARE PLANS
(Please Note: Most states have the same LCD#, but are listed separately by state.)
- Cahaba Government Benefit Administrators, LLC
- CGS Administrators, LLC
- First Coast Service Options, Inc.
- NGS (National Government Services, Inc.)
- Noridian Healthcare Solutions, LLC
- Novitas Solutions, Inc.
- Palmetto GBA
- WPS (Wisconsin Physicians Service Insurance Corporation)
MEDICAID PLANS
- Medicaid of Vermont
Cost of TMS for a Cash Patient
For an individual without access to insurance or prefer to privately pay for treatment, Anew Era TMS & Psychiatry will review the total cost for a course of TMS treatment. The private pay provides increased confidentiality and delays or treatment interruptions that can be associated with using insurance.
For more information and to review TMS treatment costs, contact Anew Era TMS & Psychiatry today at (888) 503-1549
Anew Era TMS & Psychiatry
Anew Era TMS & Psychiatry provides Transcranial Magnetic Stimulation (TMS) for those suffering from medication resistant depression. Call to schedule a free consultation, review TMS Therapy Cost, and get help today!
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