Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder

TMS is covered for adults with DSM-confirmed severe Major Depressive Disorder (single or recurrent episode) for up to six weeks when the patient has failed at least one adequate pharmacologic trial or has documented medication intolerance and when a psychiatrist (MD/DO) has provided a face-to-face evaluation and order. Coverage is denied for patients with implanted magnetic-sensitive devices within 30 cm of the coil, for many neurological or seizure-related conditions, for active psychosis during the depressive episode, and for non-MDD uses (including OCD); services must be performed by appropriately qualified providers and records must support clinical necessity.

"TMS is covered for adults with a confirmed diagnosis of severe Major Depressive Disorder (single or recurrent episode) as defined by the current DSM."

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