A new TMS machine typically costs between $50,000 and $180,000, depending on the manufacturer and model. That’s just the device itself. The true cost of adding TMS to a practice includes ongoing expenses like coil replacements, annual warranties, staff training, and the physical space to house the equipment.
Purchase Prices by Manufacturer
The TMS market has several established manufacturers, and pricing varies significantly based on the technology, software features, and targeting capabilities each system offers. Here’s what you can expect to pay for a new system:
- Apollo TMS (Neurolief): $50,000 to $59,000, the most affordable option on the market.
- CloudTMS (Neurosoft): Around $53,000 for the machine and treatment chair, plus $2,500 per year for a warranty.
- MagStim: $65,000 for the entry-level Horizon Lite up to $125,000 for the Horizon Performance with advanced navigation, plus $7,000 to $9,500 per year in warranty costs.
- MagVenture: $69,000 to $89,000.
- NeuroStar (Neuronetics): $89,000 to $115,000, with lease options available. Neuronetics also uses a pay-per-session model, meaning you pay a fee every time you deliver a treatment.
- Nexstim: Around $100,000, plus $12,000 per year for the warranty.
- Brainsway (Deep TMS): $120,000 to $180,000, the most expensive option. Brainsway offers lease arrangements and risk-sharing models where you pay per use instead of a lump sum.
The price gap between the least and most expensive systems is substantial. Lower-cost devices can be perfectly adequate for standard depression treatment protocols, while higher-end systems often include neuronavigation software, broader coil options, or deeper stimulation capabilities that may matter if you plan to treat a wider range of conditions or conduct research.
Leasing vs. Buying
Many practices lease their TMS equipment rather than purchasing outright, especially when starting out. Lease terms typically run 36 to 60 months, and some agreements bundle in maintenance or coil replacement coverage, which can simplify budgeting considerably.
Leasing keeps your upfront costs low and lets you upgrade to newer technology when the term ends. The tradeoff is that you’ll pay more over time compared to buying, and you won’t own the equipment at the end unless your lease includes a buyout option. For a system in the $80,000 to $100,000 range, expect monthly lease payments to land somewhere in the low thousands, though exact figures depend on your credit, the vendor’s financing terms, and whether maintenance is included.
Some manufacturers, notably Brainsway and Neuronetics, offer risk-sharing or pay-per-click arrangements. Under these models, you pay a fee for each treatment session rather than a fixed monthly amount. This reduces your financial risk if patient volume is unpredictable, but the per-session cost can add up quickly once your practice is busy.
Used and Refurbished Systems
Pre-owned TMS machines do appear on the secondary market, though inventory is limited and unpredictable. A lightly used NeuroStar system, for example, has been listed for around $89,000, comparable to the lower end of that model’s new price range. Older or higher-use machines can be found for less, but there are real risks: warranty coverage may not transfer, coils may be near the end of their lifespan, and the manufacturer may not provide software updates or technical support for secondhand units. If you’re considering this route, verify directly with the manufacturer what support they’ll offer for a transferred device.
Ongoing Costs Beyond the Machine
The purchase price is only part of the equation. Annual warranty contracts range from $2,500 on the low end (CloudTMS) to $12,000 (Nexstim), and skipping the warranty is a gamble since TMS coils degrade with use and repairs can be expensive. Coils are consumable components that wear out after a certain number of pulses, and replacing them can cost several thousand dollars depending on the system.
You’ll also need a dedicated treatment room. TMS doesn’t require the kind of shielding that an MRI does, but you need enough space for the device, the treatment chair, and comfortable patient access. Most practices allocate a standard exam room or slightly larger space.
Staff Training and Certification
Operating a TMS system requires trained personnel. Most manufacturers provide basic device training with purchase, but many practices invest in more comprehensive clinical education. Duke University, one of the more established training programs, charges $3,550 for a three-day course covering everything from motor threshold determination to running a clinical TMS service. That course awards up to 20 continuing medical education credits. Other training programs exist at varying price points, and some states or insurers may have specific credentialing requirements.
A typical TMS practice needs at least one trained technician to administer daily treatments, plus a supervising psychiatrist. Technician salaries vary by region but represent a significant recurring expense, especially since a standard treatment course for depression involves daily sessions over several weeks.
Total First-Year Investment
Adding everything together, a realistic first-year budget for launching a TMS program looks something like this: $50,000 to $180,000 for the device (or equivalent lease payments), $2,500 to $12,000 for warranty coverage, $3,500 to $5,000 for staff training, plus the ongoing cost of a dedicated technician and treatment space. For most practices buying a mid-range system, the all-in first-year investment falls between $100,000 and $150,000 before staffing costs.
Revenue potential depends heavily on insurance reimbursement rates and patient volume. Most major insurers now cover TMS for treatment-resistant depression, and a single full treatment course generates several thousand dollars in reimbursement. Practices that maintain steady patient volume often recoup their equipment investment within 12 to 18 months, though reaching that volume takes time and referral development.