Transcranial Magnetic Stimulation - (EN0383)

Covered: initial 30–36 outpatient treatments with FDA‑approved TMS devices for unipolar MDD (age ≥15) after failed evidence‑based psychotherapy and required antidepressant trials (adults ≥18: ≥2 trials from 2 classes; adolescents 15–17: 2 trials), and initial 30–36 deep TMS for OCD (age ≥18) after ≥2 adequate medication trials and psychotherapy failure; repeat 30–36 courses are covered only if prior response (>50% for MDD; >30% Y‑BOCS for OCD) was achieved and maintained ≥2 months; maintenance TMS, TMS for other indications (e.g., migraine), accelerated protocols (TBS/SAINT/SNT) and other non‑FDA/experimental modalities are excluded. Key requirements: outpatient administration with an FDA‑approved device, face‑to‑face DSM diagnosis, documented failed medication/psychotherapy trials or documented intolerance/contraindication, validated pre/post rating scales (depression scales or Y‑BOCS), motor‑threshold/cortical mapping, and appropriate CPT coding (90867/90868/90869).