0858T — Ext trnscranl mag stimj meas
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- No explicit documentation requirements (medical records, test results, or specific clinical documentation) are specified in this Medical Policy. The policy instructs to reference the member specific benefit plan document and any applicable federal or state mandates when deciding coverage.
Key Coverage Criteria
- Behavioral disorders: Not covered by this policy text — refer to the Optum Behavioral Clinical Policy titled 'Transcranial Magnetic Stimulation' at Optum Provider Express > Clinical Resources > Guidelines/Policies & Manuals > Behavioral Clinical Policies for coverage criteria for behavioral disorders.
- None explicitly covered in this Medical Policy for UnitedHealthcare Commercial and Individual Exchange plans. (The policy states that TMS for medical (i.e., non-behavioral) conditions is unproven and not medically necessary.)
3 Active Policies
UHC-POL-transcranial-magnetic-stimulation — Transcranial Magnetic Stimulation for Treating Physical Health Conditions
UMR-POL-UMR-transcranial-magnetic-stimulation — Transcranial Magnetic Stimulation for Treating Physical Health Conditions
SUREST-POL-SUREST-transcranial-magnetic-stimulation — Transcranial Magnetic Stimulation for Treating Physical Health Conditions
Related Codes
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