Insurance Coverage

TMS is covered by all insurances, but requires prior authorization by most of them. There is usually a copay which we will discuss with you once we have confirmed coverage with the insurance company.

Some insurances seem to be relaxing their criteria for how many medication failures are required before they approve TMS. At SEPA TMS we have seen some patients now starting to get approvals even if they have never taken mediations previously. We are thrilled to see this progress. Insurance companies are now becoming more aware of the massive benefits TMS provides for patients all over the world.

How the insurance process looks at SEPATMS: 

• Step 1. A call is made by the patient to SEPA TMS or a request is put in through our website.
• Step 2. Information is given to our  TMS coordinator, who then makes contact with the patient inquiring about TMS.
• Step 3. The TMS coordinator will provide information on forms that need to be completed online and obtain release of information forms so information can be obtained from other providers.
• Step 4. Once all relevant information is received, the patient will be scheduled for a consultation with one of our doctors to evaluate if TMS is an appropriate treatment.
• Step 5. Prior to starting TMS, the patient’s insurance will be checked for benefits, such as co-pay, deductible, etc. An insurance form will be filled out that the patient will sign when they come in for their initial mapping (measurements) appointment.
• Step 6. If the patient’s insurance does not require a prior authorization, then our coordinator, the treating doctor, and the patient, will schedule a time for the initial mapping. After the mapping, the patient will receive their first TMS treatment.