TMS was first approved for depression treatment in 2008, however the medical insurance plan did not provide coverage for TMS treatment for many years. As of now TMS treatment covered by all private insurance plans as well as Medicare. Medical insurance plans allow coverage for TMS treatment once following criteria are met (with some variations as per individual insurance plan):
- Member’s age is 18 years or older
- Member meets the DMS 5 criteria for severe major depressive (single or recurrent) documented by standardized rating scales (BDI, HDRS, MADRS, PHQ-9)
- Inadequate response to 2-4 antidepressants including augmentation therapy
- Inability to tolerate psychopharmacological agents as evidenced by four trials of medications from two different agent classes with distinct side effects.
- Failure of a trial of psychotherapy
- If individual has benefited from ECT or TMS in the past.
- TMS Rx is provided using a device that is approved by FDA for treatment of MDD.