Do you qualify for Deep TMS™ ?
Diagnosis
Deep TMS is FDA-cleared for specific conditions in adults:
- Major Depressive Disorder (MDD) — specifically adults with a depressive episode who haven’t responded adequately to prior antidepressant medication treatment in the current episode.
- Obsessive-Compulsive Disorder (OCD) — as an adjunct (additional) treatment for adult patients with OCD.
- Smoking cessation support — for adults as an aid in short-term smoking cessation.
- Anxious Depression & Late-Life Depression — expanded indications for those with comorbid anxiety symptoms in MDD and depressive episodes in older adults.
Age Requirements
Generally 18+ years old. Most formal clinical parameters and many insurance policies apply to adults.
Some clinical trials and coverage definitions focus on ages 22–86 for MDD.
Treatment History
For Deep TMS to be covered or considered appropriate for MDD, many clinicians and insurers require documentation that the patient:
- Is currently in a depressive episode.
- Has had insufficient benefit from adequate trials of antidepressant medications in the current episode.
- Often has also tried evidence-based psychotherapy without sufficient benefit.
- Has detailed records of medication names, doses, duration, and reasons for stopping.
Medically Safe
Deep TMS is not suitable for patients with certain conditions, such as:
❌ Metal in or around the head (e.g., plates, aneurysm clips, cochlear implants) — because magnetic fields may interact with metal.
❌ Implanted electronic devices (pacemakers, defibrillators, vagus nerve stimulators).
❌ History of seizures or other neurological conditions that increase seizure risk.
❌ Active suicidal intent or recent suicide attempt.
❌ Psychotic disorders, bipolar disorder with psychotic features, or other conditions where rapid response is needed.
❌ Substance abuse or unmanaged addiction (varies by protocol).
❌ Pregnancy or nursing (clinically excluded until further safety is established).
These exclusions are important for safety and often part of insurance or clinical screening.
Insurance Requirements
Even if you meet FDA indications, many insurance plans will also require:
✔️ Documentation of prior treatment failures (medications and/or psychotherapy).
✔️ Clinical severity scores (from standardized depression or OCD rating scales).
✔️ Prior Authorization from the insurer before treatment begins.
Coverage specifics vary widely between plans, so providers usually submit detailed medical records to secure approval
Do you have questions about your benefits?
Call Shelly, the Finance Manager for Depression Clinic directly at 580-775-5857.