Yes. Cigna covers transcranial magnetic stimulation (TMS) as a part of its outpatient care policies, considering it a medically necessary procedure under certain conditions for treating major depressive disorder and Obessive Compulsive Disorder (OCD).¹

Transcranial Magnetic Stimulation (TMS) is an advanced treatment designed to alleviate symptoms of Major Depressive Disorder (MDD) in adults. Cigna’s coverage for Transcranial Magnetic Stimulation (TMS) stands out from many commercial insurance plans because it uniquely includes treatment for Obsessive-Compulsive Disorder (OCD), provided certain criteria are met.²

Cigna coverage policy number “EN0383”, which renewed on 3/15/2024, authorizes coverage of transcranial magnetic stimulation (TMS) for the treatment of major depressive disorder when medically necessary and consistent with coverage criteria. Please refer to page two of this document.

In order for TMS to be covered, the care must be prior authorized and the provider must attest that the following statement is true:

– age 18 years or older

– Diagnosis of major depressive disorder (unipolar), moderate-to-servere, single or recurrent episode or acute relapse, without psychosis

– Failure of two or more trials of antidepressant medications from two separate classes of antidepressant medications (a failed trial is defined as the use of an antidepressant at a therapeutic dose for at least four weeks with no benefit OR documented side effects OR medical contraindication)

– Failed trial of psychotherapy (counseling as it relates to depression)

Cigna patients are covered for additional rounds of TMS therapy for depression when the following criteria are met. Please refer to page two of this document.

– all criteria above are met prior to the initial course of TMS

– Patient experienced at least a 50% improvement in their depression as evidenced by the PHQ-9 score or other standard rating scales for depression

– Depression symptom improvement must be maintained for at least two months after the most recent course of TMS

Cigna coverage policy number “EN0383”, which renewed on 3/15/2024, authorizes coverage of transcranial magnetic stimulation (TMS) for the treatment of Obesessive-Compulsive Disorder when medically necessary and consistent with coverage criteria. Please refer to page two of this document.

In order for TMS to be covered, the care must be prior authorized and the provider must attest that the following statement is true:

– age 18 years or older

– Diagnosis of OCD ³

– Failure of two or more trials of OCD medications from two separate classes of antidepressant medications (a failed trial is defined as the use of an antidepressant at a therapeutic dose for at least four weeks with no benefit OR documented side effects OR medical contraindication)

– Failed trial of psychotherapy (counseling as it relates to OCD)

Cigna patients are covered for additional rounds of TMS therapy for OCD when the following criteria are met. Please refer to page two of this document.

– all criteria above are met prior to the initial course of TMS

– Patient experienced at least a 30% improvement in their depression as evidenced by the Y-BOCS score or other standard rating scales for OCD

– OCD symptom improvement must be maintained for at least two months after the most recent course of TMS

At Dr. TMS Therapy Griffith Psychiatry, a premier TMS clinic located throughout the Tampa Bay Area, we’re proud to be in-network with most major insurance plans, including CIGNA.

Navigating the complexities of Cigna insurance coverage for TMS Therapy can be overwhelming. That’s why Dr. TMS Therapy Griffith Psychiatry is dedicated to simplifying this process for you. If you’re a Cigna beneficiary looking to explore TMS therapy as a treatment option for depression or other conditions, our expert care coordinators are here to assist. We specialize in liaising directly with your insurance provider to obtain detailed information about your coverage for transcranial magnetic stimulation (TMS) therapy under Cigna.

Don’t let the uncertainty of insurance coverage deter you from seeking the treatment you need. Contact Dr. TMS Therapy Griffith Psychiatry today, and let us take the first step together in uncovering your Cigna benefits for TMS therapy. Our team is committed to providing you with the support and information you need to make informed decisions about your mental health care.

Customized Quotes!

The pricing for TMS therapy without insurance varies based on individual factors such as the diagnosis, treatment quantity, and illness severity. We tailor quotes to meet your specific needs and offer a deferred interest financing solution, Care Credit, which is interest-free if repaid in full within a designated period. TMS therapy is highly beneficial, and we encourage those without insurance to contact us for more information on available options.

Call us! We can help!

Insurance plans vary greatly, so to get an accurate estimate of TMS therapy costs, it’s best to contact us with your insurance details at hand. Some individuals may have no out-of-pocket expenses. Our team of insurance specialists will verify whether your insurance covers TMS therapy and clarify any associated costs for you, often providing answers on the same day.

TMS Therapy is a non-medication, FDA-approved depression treatment that is covered by insurance.