Transcranial Magnetic Stimulation as a Treatment for Psychiatric/Neurologic Disorders

This policy covers transcranial magnetic stimulation (TMS) — including conventional, deep, and theta‑burst modalities — for acute‑phase (and retreatment/maintenance) therapy of confirmed moderate‑to‑severe non‑psychotic major depressive disorder in adults (≥18), augmentation in 15–17 year‑olds, and treatment of obsessive‑compulsive disorder in adults, including use for treatment‑resistant depression after inadequate trials of ≥2 antidepressant classes and failed psychotherapy. Coverage requires use of an FDA‑cleared device following manufacturer/supported protocols with weekly standardized rating scales, prescription/supervision by a trained psychiatrist (or trained provider where access limits apply), and excludes MDD with psychotic features, seizure disorders, specified neurologic comorbidities, and other listed contraindications.

"Transcranial magnetic stimulation (including conventional TMS, deep TMS, and theta-burst) for acute‑phase treatment of confirmed moderate-to-severe non‑psychotic major depressive disorder (MDD) in ..."