Insurance & Coverage

TMS Therapy Is Covered by Most Major Insurance Plans

TMS therapy for depression is no longer a niche, out-of-pocket expense. Most major insurers now cover it — and our team handles the entire verification and authorization process for you, at no charge.

We Verify Your Benefits

Before your first appointment

We contact your insurance company directly to confirm your coverage, deductible status, and any out-of-pocket costs before treatment begins — so there are no surprises.

We Handle Prior Auth

End-to-end authorization support

Prior authorization can be a barrier. Our staff manages the entire process — submitting clinical records, letters of medical necessity, and following up with your insurer on your behalf.

Clear Cost Estimates

Transparent, upfront information

Once we've verified your benefits, we'll walk you through exactly what your plan covers and what your expected out-of-pocket responsibility will be before you commit to treatment.

In-Network Insurance Partners

Palo Alto TMS is currently in-network with the following major insurance providers. Don't see yours? Contact us — out-of-network benefits may still apply.

Aetna

In-network

Anthem Blue Cross

In-network

Blue Shield of California

In-network

Carelon

In-network

Cigna

In-network

Evernorth

In-network

Magellan Health

In-network

Optum

In-network

How the Insurance Process Works

We've streamlined the process so you can focus on getting better — not on paperwork. Here's what happens from first contact to first treatment.

Step 1 — Benefits Verification

Once you contact us, our team reaches out to your insurance company to verify your coverage for TMS therapy. We confirm whether TMS is a covered benefit under your plan, your deductible and out-of-pocket maximum status, and any applicable co-pays or co-insurance.

Step 2 — Cost Consultation

We walk you through the results of the verification call and provide a clear, honest estimate of any out-of-pocket costs. We want you to have a full financial picture before making any decisions.

Step 3 — Prior Authorization

If your plan requires prior authorization, our clinical team prepares and submits all required documentation — including medical history, prior treatment records, and a letter of medical necessity. We follow up with your insurer until approval is secured.

Step 4 — Begin Treatment

Once authorization is in place, we schedule your initial consultation and treatment sessions. Our team continues to manage billing and communicate with your insurer throughout your course of care.

Our team handles insurance verification and prior authorization paperwork on your behalf

Out-of-Network & Self-Pay Options

If your insurance plan does not cover TMS therapy or you are uninsured, you may still be able to access treatment.

Out-of-Network Benefits

Your plan may still help

Even if we are not in-network with your insurer, many plans offer out-of-network benefits that reimburse a portion of your treatment costs. We will help you understand what your plan offers and provide the documentation needed for reimbursement claims.

Self-Pay

Flexible private-pay arrangements

For patients paying out of pocket, we offer transparent self-pay pricing. Contact us to discuss rates and payment arrangements that work within your budget.

Appeals & Denials

We advocate for your coverage

If your initial insurance claim is denied, we can assist with the appeals process. Our team has experience preparing clinical appeals documentation and working with insurers to overturn denials for medically necessary TMS therapy.

Frequently Asked Questions

Common questions about insurance coverage for TMS therapy.

Yes. Many major insurance plans now cover TMS therapy for treatment-resistant depression. Palo Alto TMS is in-network with Aetna, Anthem Blue Cross, Blue Shield of California, Carelon, Cigna, Evernorth, Magellan, and Optum. Coverage specifics vary by plan — contact us and we will verify your benefits at no charge.

Prior authorization is your insurance company's approval process before they agree to cover a treatment. Most insurers require it for TMS therapy. Our clinical team handles the entire prior authorization process on your behalf — submitting your medical history, prior treatment records, and a letter of medical necessity directly to your insurer.

Some insurance plans require a referral from a primary care physician or psychiatrist before approving specialist care. Our team will review your specific plan requirements during the benefits verification process and advise you on whether a referral is necessary before you schedule.

If your plan does not cover TMS or you are uninsured, out-of-network reimbursement and self-pay options may still be available. If a claim has been denied, we can also help with the appeals process. Contact us to discuss your situation — we are committed to helping you find a path to care.

Let Us Verify Your Benefits — At No Charge

Not sure if your insurance covers TMS? Contact us today and our team will reach out to your insurer, confirm your benefits, and walk you through your options before you commit to anything.

Contact Us to Verify Coverage (415) 735-4867