Transcranial Magnetic Stimulation (TMS) - MEDICAID - LOUISIANA

Transcranial Magnetic Stimulation (TMS) is covered for treatment of major depressive disorder in Medicaid Louisiana for adults (≥18) who have failed or are intolerant to pharmacotherapy—generally defined as lack of clinically significant response to four trials from at least two different antidepressant classes (with at least two trials being adequate courses of ≥6 weeks), or who cannot take antidepressants, or for whom electroconvulsive therapy (ECT) has been attempted, declined, or is contraindicated; retreatment requires a prior TMS response of ≥50% reduction in baseline depression scores and current worsening of ≥50% from the prior best PHQ‑9. Coverage is denied for patients with contraindications such as metal or magnetic-sensitive implants near the coil (e.g., deep brain stimulators, cochlear implants, pacemakers), history or risk factors for seizures (excluding ECT‑induced seizures), active psychosis/catatonia requiring rapid response, active suicidality, severe cardiovascular disease, severe dementia, substance abuse, and other specified implant/seizure risks.