Medicare does cover transcranial magnetic stimulation (TMS), but only for specific diagnoses and only after you’ve tried other treatments first. The most established coverage is for severe major depressive disorder (MDD), and you’ll need to meet several clinical criteria before Medicare will approve it.
What Medicare Covers TMS For
TMS is covered under Medicare Part B as an outpatient procedure. The primary covered use is for severe major depressive disorder, either a single episode or recurrent. To qualify, you need a confirmed diagnosis of severe MDD as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Some Medicare Administrative Contractors (the regional companies that process Medicare claims) have also begun covering deep TMS for treatment-resistant obsessive-compulsive disorder (OCD). However, this coverage varies by region and is less uniformly available than depression coverage. For all other conditions, including smoking cessation and anxiety, Medicare generally considers TMS experimental and does not cover it.
Eligibility Requirements for Depression
Medicare won’t cover TMS as a first-line treatment. You must have tried and failed at least one antidepressant medication, or you must have demonstrated an intolerance to psychiatric medications. “Failed” in this context means the medication didn’t adequately control your symptoms after an appropriate trial period at an adequate dose.
This threshold is lower than what many people assume. Some private insurers require four or more failed medication trials before approving TMS, but Medicare’s local coverage determinations typically require just one. Your prescribing physician will need to document your treatment history, including which medications you tried, at what doses, for how long, and why they were considered unsuccessful.
How Many Sessions Are Covered
Medicare covers an initial course of TMS treatment lasting up to six weeks. A standard course typically involves sessions five days per week, which works out to roughly 30 sessions total. Each session lasts between 20 and 40 minutes depending on the type of TMS used.
Coverage beyond the initial six-week course is less straightforward. If you respond well to treatment but later relapse, your provider may be able to request authorization for additional sessions. The documentation requirements for retreatment are generally stricter, and your physician will need to demonstrate that you had a meaningful response to the first round.
Supervision and Provider Requirements
TMS must be prescribed and administered under the direct supervision of a licensed physician who is trained and experienced in repetitive transcranial magnetic stimulation. “Direct supervision” means the physician must be physically present in the treatment area during your session, though they don’t have to personally operate the device. A trained technician can deliver the pulses while the supervising physician remains nearby.
This requirement matters because not every clinic offering TMS meets Medicare’s supervision standards. Before starting treatment, confirm that the facility bills Medicare directly and that a qualified physician will be on-site during each of your sessions. If the supervision requirement isn’t met, Medicare can deny the claim after the fact, leaving you responsible for the full cost.
Your Out-of-Pocket Costs
Because TMS falls under Part B, you’re responsible for the standard Part B cost-sharing structure. That means you’ll pay 20% of the Medicare-approved amount after meeting your annual Part B deductible (which is $257 in 2025). If you have a Medigap (Medicare Supplement) plan, it may cover some or all of that 20% coinsurance depending on which plan letter you carry.
Medicare Advantage plans also cover TMS, since they’re required to cover everything Original Medicare covers. However, Advantage plans can impose their own prior authorization requirements and may use a narrower network of approved TMS providers. Check with your specific plan before scheduling treatment, as the prior authorization process can take several weeks and getting treated at an out-of-network facility could significantly increase your costs.
Regional Differences in Coverage
There is no single national coverage determination for TMS. Instead, coverage policies are set by Medicare Administrative Contractors (MACs), the regional entities that handle claims processing in different parts of the country. This means the specific requirements you face depend on where you live.
The core criteria are similar across regions: a severe MDD diagnosis and at least one failed medication trial. But the details can differ. Some MACs have more explicit documentation requirements, others may have slightly different rules around retreatment, and coverage for OCD varies significantly by region. Your TMS provider’s billing department will typically know the exact requirements for your local MAC and can help ensure your paperwork meets the criteria before treatment begins.