- The condition being treated
- If you have depression, how many antidepressants you’ve tried without successful symptom control
- Your insurance coverage (e.g. your copay, coinsurance, and deductible)
Does Insurance Cover TMS Treatment Cost?
All major insurance companies cover the cost of TMS for the treatment of depression. Patients are responsible for paying their deductible and copays, the cost of which will vary depending on the insurance policy. Contact your insurance provider to learn more.
At Madison Avenue TMS & Psychiatry, we accept every major insurance plan. Even if we’re not in your insurance company’s network, we can arrange coverage with them. Learn more about paying for TMS with insurance.
TMS is typically covered by insurance when the patient has tried at least 4 antidepressants from 2 different drug classes (SSRIs, SNRIs, TCAs, MAOIs, or atypical agents) without successful symptom control. Contact us or call your insurance company if you have questions about whether TMS would be covered for you.
Is TMS Covered by Medicare and Medicaid?
Medicare covers 80% of the cost of TMS for the treatment of depression. Patients who also have secondary insurance will oftentimes pay less than 20%, and may even pay nothing at all.
In the state of New York, the only Medicaid provider that currently offers coverage for TMS is Healthfirst Medicaid Management.
How Much Does Transcranial Magnetic Stimulation Cost in NYC?
The cost per TMS session varies depending on your level of insurance coverage. If you’re paying with insurance, you’ll pay anywhere between $10 and $70 per session, depending on your plan’s copay or coinsurance rate. A total of 36 sessions, plus one brain mapping session, are required to complete the treatment course.
Please be aware that some patients’ insurance plans include a deductible that will need to be met before the coinsurance or copay becomes the portion of the cost that the patient is responsible for.
We offer flexible payment plans for patients paying out-of-pocket, or for patients who need help with their copay/coinsurance fees.
How Does TMS Treatment Cost Compare to the Cost of Antidepressants?
Many patients find that TMS treatment cost ends up being comparable to the cost of antidepressants. Even with insurance coverage for prescription medications, antidepressants can cost up to $150 per month, or $1,800 over the course of a year. TMS could cost as low as $370 for an entire 9-week course of treatment, with results lasting over a year in 62.5% of patients.
In addition to being a cost-effective alternative to antidepressants, TMS is effective in relieving symptoms of treatment-resistant depression and has almost no side effects.
TMS for Conditions Other Than Depression
TMS is a safe and effective treatment for many conditions other than depression. However, insurance providers generally do not yet cover the cost of TMS therapy for the following conditions:
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Traumatic brain injury (TBI)
Out-of-pocket payment plans are available for individuals with these conditions. We offer flexible payment options, and can work with our patients to set up plans that are affordable for them.
Questions About TMS Cost in NYC?
If you have any questions regarding the cost of TMS treatment in New York City, or about insurance coverage for TMS, call our office at contact us online or call us at (212) 731-2033.