Billing and Coding: Transcranial Magnetic Stimulation (TMS)

TMS is covered for treatment of depressive symptoms when provided with an FDA‑approved device and when medical necessity is documented and monitored with validated depression rating scales; the attending physician must document clinical progress. Coverage allows an initial course of up to 20 visits over 4 weeks plus 5 tapering visits, with conditional extension of up to 10 additional visits plus 6 tapering visits for patients with ≥25% improvement; retreatment is permitted for patients who previously responded (>50% improvement) or relapsed after remission. Maintenance (ongoing) TMS is considered experimental/investigational and is not covered.

"Transcranial magnetic stimulation (TMS) is covered for treatment of depressive symptoms when administered using an FDA‑approved TMS device and when medical necessity is documented in the medical re..."

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