Do I Qualify for TMS Therapy?

Mind Shine, LLC TMS Therapy and Mental H

Am I a Good Candidate For TMS?   Does My Insurance Cover the Treatments?

One common questioned asked for those seeking information about TMS therapy is…. Does my health insurance cover TMS therapy?

This is one of the many areas Mind Shine TMS can help pave a smoother path for those seeking TMS therapy.  Fortunately, TMS therapy is covered by most Health Plans, including those listed here.  And although TMS therapy is a covered service for many health plans, we recognize that navigating one’s policy is often challenging and frustrating.  This is where Mind Shine TMS will assist. We will work directly with your insurance company to verify your benefits and gain coverage.  Let me review the Mind Shine TMS approval process…

The first step is for us to understand your current clinical situation and determine if you are a candidate for TMS therapy. Most health insurance coverage policies, including MEDICARE, require the following:

 - That you have been diagnosed with Major Depressive Disorder.

 - That you have failed to receive benefit from multiple medications.

 - That at this current time you are depressed.

This is easily determined by one of several depression measuring scales and by a doctors’ observations during a consultation.  Also, many insurance companies want to understand your current and previous experience with psychotherapy. Also referred to as Talk Therapy, CBT or IBT.


Lastly- we will also ask general health questions to be sure there are no conditions that may exclude you from TMS.  

Once we understand that your current situation meets most health insurance criteria, we will then investigate your specific health insurance benefits.  This is called a benefit investigation. It will answer two important financial questions.

Is TMS a covered service?  And, what, if any, will be your out-of-pocket costs?

To perform a benefits investigation, we will need you to provide us details that are on your insurance card and some personal contact information. You can do this by phone or through our electronic system.

The next step will be for you to meet with our physician to complete a TMS medical consultation. The goal of the consultation is for the physician to understand your clinical condition and record specific information required by your health insurance.  Mind Shine TMS will submit this information to your health insurer to gain their approval as quickly as possible,  so you can begin TMS therapy and the path to better health.  

Please call us for more information about TMS therapy or for us to help with your insurance benefits.  We look forward to getting to know you.

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