As a relatively recent addition to the mental health treatment field, TMS has not yet achieved widespread recognition. Among the many questions that people have about this procedure are: Who can benefit from TMS? What happens during a TMS session? and Is TMS covered by insurance?
What Is TMS?
Before we discuss if TMS is covered by insurance, let’s take a moment to discuss what this service is and why it may be included in a person’s mental health treatment plan.
TMS stands for transcranial magnetic stimulation. It is a noninvasive procedure that has proved to be beneficial for people who had been struggling with several types of mental health disorders. The process involves the focused application of electromagnetic pulses to stimulate areas of the brain that may not be functioning properly.
TMS was originally approved by the U.S. Food and Drug Administration (FDA) in 2008 to treat people who had treatment-resistant depression (TRD). Though there is not an official diagnosis for TRD in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), most clinicians define it as major depressive disorder that does not respond to at least two separate medications.
Through the years, TMS has also earned FDA approval for the treatment of people who have obsessive-compulsive disorder (OCD) and migraines, as well as those who are trying to quit smoking.
Researchers are currently assessing the potential benefits of TMS for people who have a variety of additional mental, physical, and neurological concerns, including:
- Alzheimer’s disease
- Bipolar disorder
- Borderline personality disorder (BPD)
- Posttraumatic stress disorder (PTSD)
- Schizoaffective Disorder
- Dual Diagnosis disorders
TMS may also be helpful for people who have been affected by certain physical or neurological health challenges, such as fibromyalgia, traumatic brain injury, Alzheimer’s disease, Parkinson’s disease, and chronic pain.
What Happens During a TMS Session?
At the outset of a TMS session, the patient is usually seated in a comfortable chair and provided with a set of earplugs. Although TMS is a painless, noninvasive procedure, the machine that generates the electromagnetic pulses can be quite noisy at times.
Next, the professional who is conducting the session will place a small magnetic coil against the patient’s scalp, usually near their forehead.
When the TMS device is activated, it will generate a series of brief electromagnetic pulses. These pulses will penetrate the patient’s skull and reach an inch or two into their brain. In the brain, they will stimulate activity within the neurons that are located in a small area directly beneath the coil.
While this is occurring, most patients feel nothing more than a light tapping at the spot where the coil is placed against their scalp.
TMS does not require anesthesia, so patients are awake and alert throughout the entire process. Once the session is over (which typically takes about 30 minutes), most patients can fully resume all normal daily activities, including driving a car and going back to work.
Before a patient begins their first TMS session, the professional who provides their care will review the process in detail, discuss possible side effects, and answer any questions that the patient has.
Is TMS Covered by Insurance?
During the experimental phase and after TMS initially earned FDA approval, this service was not covered by most insurance providers. However, as its use expanded and positive results continued to be documented, insurers began to pay for the procedure. Today, the answer to the question, “Is TMS covered by insurance?” is that sometimes it is, but sometimes it is not.
The types of services that are covered – and the amount of coverage that is provided – can vary from company to company and from policy to policy. The only way to be sure if TMS is covered by your insurance is to review the details of your policy.
At Atlanta Integrative Psychiatry, we understand that navigating the complexities of an insurance policy can be far from a simple matter. Our team includes professionals who specialize in doing just this, and we are happy to help our patients with this task.
With your permission, we can coordinate directly with your insurance provider to confirm your coverage and identify the full scope of benefits to which you are entitled. If TMS is covered by your insurance, we can submit all necessary documentation to ensure that your provider pays for this aspect of your treatment. If it turns out that your insurance policy does not include coverage for TMS, we will discuss this with you and explore other options for funding your care.
Find a TMS Provider in Atlanta, GA
Atlanta Integrative Psychiatry is a trusted provider of TMS therapy and a variety of additional evidence-based outpatient mental health treatment services. If you or someone in your family have been living with major depressive disorder, obsessive-compulsive disorder, or another acute mental health concern, our team can help. At our center in Atlanta, Georgia, you or your loved one can receive personalized care and comprehensive support from a team of skilled professionals. With our help, you can make sustained progress toward a healthier and more hopeful future.
When you’re ready to get started, the Atlanta Integrative Psychiatry Team is here for you. To learn more or to schedule a free assessment, please visit our admissions page or call us today.