Insurance companies currently approve TMS coverage primarily for Major Depressive Disorder (MDD). However, many individuals with PTSD also meet criteria for MDD, making them eligible for insurance-covered TMS. Brain Wellness Center can assess your symptoms and explore coverage options.
Major Depression is a clinical diagnosis based on symptoms such as persistent sadness, fatigue, loss of interest, and sleep disturbance. For insurance coverage, most providers define MDD as scoring 20 or higher on the PHQ-9 depression scale. This form is available on the Brain Wellness Center website.
No. TMS is a covered benefit under most plans in California, but prior authorization is required. Brain Wellness Center handles all insurance communications and paperwork for you.
Currently, no insurance plan covers TMS for children. Some plans may consider coverage for patients 15 years or older, but most require the patient to be at least 18 years of age. Brain Wellness Center can discuss alternative options for younger individuals experiencing PTSD.
