TMS: the complete guide
TMS (transcranial magnetic stimulation) uses a magnetic coil held against the scalp to stimulate the left dorsolateral prefrontal cortex. No anesthesia and no medication. Insurers and Medicare look for depression plus two to four failed antidepressant trials. Sessions are 20 to 40 minutes for six weeks, then a taper, 36 sessions in total. A ride home is not required.
Updated · Checked by the Covered Mind editorial team against cited sources
How transcranial magnetic stimulation treats depression, who qualifies under insurance, what six weeks of daily sessions involve, and what it costs.
Key facts
- Last checked:
- Sources listed: 2
- Reading time: About 2 minutes
- Session length: 20 to 40 minutes
- Standard course: 36 sessions
- Insured cost: $20 to $90 per session
- Cash price: $250 to $500 per session
| Fact | Value |
|---|---|
| Last checked | |
| Sources listed | 2 |
| Reading time | About 2 minutes |
| Session length | 20 to 40 minutes |
| Standard course | 36 sessions |
| Insured cost | $20 to $90 per session |
| Cash price | $250 to $500 per session |
What it is
TMS uses a magnetic coil held against the scalp to deliver pulses that stimulate the left dorsolateral prefrontal cortex, a region underactive in depression. No anesthesia, no medication, no memory effects. The FDA cleared it for major depression in 2008 and for obsessive-compulsive disorder in 2018; newer protocols (theta burst, deep TMS, accelerated schedules) are cleared as well. Check your plan in the coverage checker and read TMS coverage by insurer. See the TMS overview for the treatment schedule and answers to common questions.
Who qualifies
Insurers and Medicare converge on the same criteria:
- Moderate to severe major depressive disorder on a standard rating scale.
- Failure of two to four antidepressant trials at adequate dose and duration (or intolerance).
- A trial of evidence-based psychotherapy, or a documented reason it was not appropriate.
- No seizure disorder and no ferromagnetic metal in or near the head.
TMS for OCD, PTSD or anxiety is usually excluded from coverage even where it is FDA cleared.
Read TMS for treatment-resistant depression, TMS for OCD and TMS for PTSD. Read TMS for anxiety.
What treatment involves
- Mapping visit:
- the clinician locates your motor threshold to set the dose. About an hour.
- Daily sessions:
- 20 to 40 minutes, five days a week, for six weeks, then a taper of six sessions over three weeks. Standard courses total 36 sessions. Accelerated protocols compress this into one to two weeks with several sessions a day.
- Sensation:
- tapping on the scalp and jaw muscle twitching. Headache and scalp discomfort are the common side effects and fade within the first week. Seizure risk is under 1 in 1,000 with screening.
You drive yourself home. Most people work the same day.
What results can TMS show?
About half to two thirds of patients respond, and roughly a third reach remission after a first course. Effects last a year or more for many; re-treatment for relapse is covered when the first course produced a documented response.
Do Medicare and commercial plans cover TMS?
Most commercial plans and Medicare cover TMS. Prior authorization rules depend on the plan. Check with yours. See TMS coverage by insurer and Medicaid coverage by state. Compare schedule and insured cost in Spravato vs TMS. See TMS vs ECT: what each is for.
What does TMS cost?
Insured patients typically pay $20 to $90 per session after deductible, so plan your out-of-pocket maximum: 36 sessions add up quickly. Cash prices run $250 to $500 per session or $6,000 to $14,000 per course. See TMS cost.
Related reading: Maintenance for Spravato, ketamine and TMS and Side effects and safety: Spravato, ketamine and TMS.
Sources
Related
Checked by the Covered Mind editorial team · · Editorial policy
Cite this
Covered Mind. "TMS: the complete guide." https://www.coveredmind.com/guides/tms-complete-guide. Last checked Sep 1, 2026.
This site provides general information about insurance coverage and treatment options. It is not medical advice, not a guarantee of coverage, and not a substitute for talking with a clinician or your health plan.