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Does TRICARE Cover TMS Therapy?

Does TRICARE Cover TMS Therapy?

Does TRICARE Cover Transcranial Magnetic Stimulation (TMS)?

Yes, TRICARE covers transcranial magnetic stimulation (TMS) as an outpatient procedure.1

TMS is used in the treatment of Major Depressive Disorder (MDD) in adults who are on active duty or retired members of the armed forces. In addition, the spouse or child of a serving or retired member of the military and members of the National Guard or Reserve are also eligible for TRICARE TMS coverage.

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How to Verify TMS Therapy TRICARE Coverage

Athena Care, a TMS clinic in Tennessee, is in-network with most major insurance plans. To determine if your TRICARE insurance covers TMS therapy, contact us below. Let our expert care coordinators handle the challenges of contacting your insurance carrier for more information about TRICARE transcranial magnetic stimulation coverage.

What is Transcranial Magnetic Stimulation?

Transcranial Magnetic Stimulation (TMS) is a non-invasive mental health treatment for delivering electrical stimulation to the brain in patients with treatment resistant depression (TRD) and other psychiatric and neurologic illnesses like post-traumatic stress disorder (PTSD).

The procedure entails placing a tiny coil on the scalp and passing a quickly alternating current via the coil wire. The electrical current creates a magnetic field that penetrates the scalp and bone without obstructing, stimulating neural activation.  

In a study published in the journal Biological Psychiatry, TMS therapy was investigated to treat individuals with both major depressive disorder (MDD) and PTSD, as these illnesses frequently coexist.2 The dorsolateral prefrontal cortex (DLPFC) was treated with TMS. Patients received roughly 36 sessions, lasting anywhere from 15-40 minutes over several weeks.

According to the findings, one-third of the patients improved their symptoms considerably. This is a lower response rate than for either condition alone. Still, considering the severity of the illness, this is acceptable. According to the researchers, the enhanced connection between the prefrontal cortex and the amygdala resulted in this positive response.

People who have certain medical implants will not be able to receive TMS treatment. Metal implants or gadgets that interact with magnetic fields may cause problems. Additionally, if you have stents, implanted stimulators, a pacemaker, a medication pump, cochlear implants, or gunshot fragments in your body, you may not be eligible for TMS therapy. To avoid any adverse outcomes, it’s crucial to discuss these issues with your mental health care provider before starting TMS therapy.

TMS is also not recommended for people with certain medical disorders, such as a history of seizures or bipolar disease. It is also not recommended for women who are pregnant.

Finally, inform your TMS doctor about any prescription or over-the-counter medications, supplements, or vitamins you’re taking. Depending on anything you’re regularly taking, they’ll need to ensure that TMS therapy is safe for you.

How Much Does TMS Cost Without Insurance?

The following are average costs for TMS therapy without TRICARE TMS coverage. These costs may vary by location and other factors, and they may not reflect the actual cost of what you may pay in Tennessee.

TMS therapy sessions typically cost between $400 and $500 per session.3 Because most people require multiple sessions to achieve optimal outcomes, the total cost of TMS could be about $15,000.

Sources

  1. “Transcranial Magnetic Stimulation.” TRICARE, Department of Defense, 20 Mar. 2022, www.tricare.mil/CoveredServices/IsItCovered/TranscranialMagneticStimulation
  2. Success TMS. “TMS Therapy for PTSD | Success TMS Depression Treatment.” Success TMS, Success TMS, 2 Mar. 2020, successtms.com/tms-for-ptsd
  3. Porter, Robert. “What Does TMS Therapy Cost? TMS Information | BetterHelp Advice.” Betterhelp, BetterHelp, 20 Apr. 2022, www.betterhelp.com/advice/therapy/how-much-does-tms-therapy-cost

If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.

One of our friendly associates will help you get the help you need. Take this first step to feel better and take control. 

(615) 320-1155