Billing and Coding: Transcranial Magnetic Stimulation

Transcranial magnetic stimulation is covered when delivered with an FDA-approved/cleared TMS device and documented per the related LCD; the attending physician must document clinical progress using validated depression rating scales. Retreatment/ repeat treatment programs are allowed for patients who previously responded (>50% improvement on standard scales) or relapsed after remission, but maintenance therapy is not covered; CPT 90867 (TMS treatment planning) is billable once per treatment episode. Claims must include a valid ICD-10-CM diagnosis and, when required, the referring/ordering physician's name and NPI; coding may be subject to NCCI/OPPS edits.

"TMS is covered when provided using a device approved or cleared by the U."

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