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TMS for OCD: Is TMS Covered by Insurance for Obsessive-Compulsive Disorder?


Deep TMS (dTMS) is scientifically proven to treat obsessive-compulsive disorder (OCD) and was FDA-approved to treat OCD in 2018. (1,2,3) Madison Ave TMS & Psychiatry is proud to offer BrainsWay Deep TMS to patients diagnosed with OCD. 

As of May 2021, TMS for OCD is not yet covered by insurance providers. However, even though dTMS is not covered specifically for the treatment of OCD, that doesn’t mean you can’t get dTMS for OCD.

Insurance Coverage for dTMS for OCD

Many people diagnosed with OCD also experience depression, and dTMS for depression is covered by insurance. This means that if you meet the qualifications to have dTMS covered by insurance for depression, and you also have OCD, you could see improvements in OCD symptoms from undergoing dTMS for depression. Take our quiz to find out whether you’re a candidate for TMS for depression, or call us at (212) 731-2033 to find out whether your insurance will cover you.

Paying for dTMS Without Insurance

Another possibility is to pay for dTMS for OCD out of pocket. Our practice offers payment plans for this, and we can work with you on rates. Contact us to learn more. 

How Does TMS Treat OCD?

Obsessive-compulsive disorder is characterized by recurring and unwanted thoughts, sensations, and/or behaviors. Research suggests that OCD is caused by abnormal activity in certain regions of the brain that communicate with each other and create a system called the CSTC (cortico–striato–thalamo–cortical) loop. (4)

Deep TMS is a treatment option for OCD that helps regulate brain activity using magnetic pulses, without medication. During deep TMS treatment sessions, a technician fits the patient with a helmet that contains a magnetic coil. This magnetic coil safely delivers repeated magnetic pulses to a predetermined area of the head. These magnetic pulses electrically stimulate neurons (nerve cells found in the brain) in the targeted area to normalize brain activity. (5)

Deep TMS can be combined with other OCD treatments, including medication, to augment these treatments and improve results.  

What Will Insurance Coverage for TMS for OCD Look Like in the Future?

While TMS therapy for OCD treatment is approved by the FDA, insurance providers don’t yet cover it. We hope that insurance providers will start offering coverage for OCD treatment with TMS in the near future.

That being said, there’s no way to know how insurance providers will cover TMS for OCD, but they will likely follow similar guidelines that are currently outlined for the coverage of TMS for depression. Most major insurance providers cover TMS treatment costs for depression only after patients have failed first-line treatments. Typically, for insurance providers to cover TMS for depression, a patient’s physician must prove that the patient has tried multiple antidepressants without seeing improvement in their symptoms, or show that the patient is intolerant (has a severe adverse reaction) to antidepressants, in addition to psychotherapy. OCD is typically treated with medication and a type of cognitive-behavioral therapy called exposure and response prevention.

Insurance coverage for TMS therapy is determined on a case-by-case basis, and coverage varies depending on the patient’s insurance provider and their specific plan.

Managing the Cost of TMS for OCD

At Madison Ave TMS & Psychiatry, we help our patients finance TMS treatment when their insurance providers don’t cover the costs. Learn more about the costs of TMS here

If your insurance plan does not mention deep TMS for OCD, we can work with you to develop a payment plan that best fits your financial situation. To learn more about how we can help you finance TMS treatment, contact us online or call us at (212) 731-2033. 


Resources:

1. FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. Published August 17, 2021. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder. Accessed April 10, 2021.

2. Carmi L, Tendler A, Bystritsky A, etal.  Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Prospective Multicenter Randomized Double-Blind Placebo-Controlled Trial. Am J Psychiatry. 2019;176(11):931-938. https://pubmed.ncbi.nlm.nih.gov/31109199/. Accessed April 10, 2021.

3. Carmi L, Alyagon U, Barnea-Ygael N, et al. Clinical and Electrophysiological Outcomes of deep TMS Over the Medial Prefrontal and Anterior Cingulate Cortices in OCD Patients. Brain Stimul. 2018;11(1):158-165. https://pubmed.ncbi.nlm.nih.gov/28927961/. Accessed April 10, 2021.

4. Calzà J,  Gürsel DA, et al. Altered Cortico–Striatal Functional Connectivity During Resting State in Obsessive–Compulsive Disorder. Front Psychiatry. 2019; 10: 319. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524661/#__ffn_sectitle. Accessed April 10, 2021.

5. YouTube Video. An In-Depth Look At BrainsWay Patented Technology For Brain Disorders. Published January 07, 2018. https://www.youtube.com/watch?v=pdChE7USKdU. Accessed April 11, 2021

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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If you're in the New York City area, contact us online to check your insurance coverage and schedule your first appointment.

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