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Does Medicare Cover TMS for Depression?

TMS Therapy has become a more common treatment of Depression.

For those over 65 who suffer from Depression, a common question to ask is “does Medicare cover TMS for Depression?”

You’ll find a clear, straightforward answer to that question below. There is also information about TMS therapy costs and other helpful info.

Does Medicare Cover TMS for Depression?

Yes, Medicare covers TMS therapy in patients suffering from Major Depressive Disorder. However, before Medicare covers a TMS session, there are specific criteria that the patient has to meet. Here are the criteria that the patient has to meet to be eligible for TMS therapy:

  • A diagnosis of Major Depressive Disorder
  • The patient has gone through a single trial of antidepressants, but it had no effect
  • The inability to tolerate two different antidepressants from 2 different classes
  • The patient has undergone a trial of evidence-based psychotherapy effective against major depressive disorder but has no significant patient improvement.

If you meet the criteria above, Medicare will shoulder the cost of TMS.

How Much Does TMS Cost?

TMS therapy can cost between $400 to $500 per session. Considering that most people need a series of treatments, the overall costs can go as high as $15,000.

But because TMS is proven to be effective against depression, many health insurance companies, like Medicare, are covering the costs. However, it is essential to know that not all health insurance companies cover TMS therapy.

About TMS Therapy

Transcranial magnetic stimulation (TMS) is a procedure in which it uses magnetic fields to help a patient improve and overcome symptoms of depression. As for every session’s procedure, an electromagnetic coil is placed against the person’s scalp near their foreheads.

Then once the machine is activated, the electromagnet delivers a magnetic pulse to stimulate nerve cells in the region of the brain that is involved in mood control and depression. As a result, this activates parts of the brain which activities have decreased because of depression.

TMS is a non-invasive and painless procedure used in people suffering from depression. It is often used when other depressive treatments are not effective on patients. This procedure takes many sessions to improve the patient’s condition, and repetitive sessions are called repeated TMS or rTMS.

What Are The Side Effects Of TMS?

Even though TMS is a non-invasive, painless, and comfortable procedure, it has some side effects. Some common. Some rare. Common side effects of TMS may include:

  • Headaches
  • Discomfort at the scalp
  • The facial muscles may twitch, or tingle
  • The patient may feel lightheaded

Some rare side effects of TMS may include:

  • Seizures
  • The patient may develop mania; this usually happens to patients with bipolar disorder
  • Loss of hearing due to inadequate ear protection during treatment

Preparations Needed Before Undergoing TMS Treatment

Before undergoing an rTMS session, you may need a physical exam and lab tests or other tests, and a psychiatric evaluation.

Factors That May Prevent You From TMS Sessions

  • Pregnancy
  • Implanted or metal medical devices
  • Intake of any medications
  • Seizures or history of seizures
  • Other mental health disorders
  • Brain damage due to injury or illness
  • Frequent headaches
  • Severe headaches
  • Other medical conditions

Though it can be expensive, TMS treatment is an effective and safe way to treat Major Depressive Disorder. And with Medicare insurance, they may cover each TMS session.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover Naturopathic doctors?

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