Harmony Health Group Accepts BCBS Insurance for TMS Therapy
Mental health concerns can be pervasive and chronic experiences, including depression, anxiety, OCD, and PTSD. Some find that they continue to experience hardships because of their conditions, even with the use of psychotherapy and medications. While this may leave you feeling as though there is no way for improvement, transcranial magnetic stimulation (TMS) may be a treatment option.
The Harmony Health Group manages several mental health treatment programs and behavioral services on the East Coast, some of which provide TMS services covered by BCBS insurance. You will find that each of our treatment facilities provide specialized and holistic care, in a warm and welcoming environment. Individualized care is a priority, as we work diligently to ensure that you receive the care you need for a lasting recovery. If you have been struggling with mental health symptoms, we encourage you to contact the Harmony Health Group to learn about affordable mental health treatment options near you!
Check Your BCBS TMS Therapy Coverage Levels with Harmony Health Group
You can check your insurance coverage levels by calling us on: (866) 461-4474
What is Transcranial Magnetic Stimulation (TMS)?
Transcranial magnetic stimulation (TMS) is a non-invasive procedure that has been FDA-approved for treating various mental health disorders. In most cases, individuals who receive TMS have tried psychotherapy, medications, and holistic practices, and have not experienced a decrease in the frequency or intensity of their mental health symptoms.
During a TMS session, an electromagnetic coil is placed on your scalp to send magnetic pulses to nerve cells in different areas of your brain, typically targeting areas that are tied to the symptoms you’re experiencing. TMS does not create a risk for seizures or memory loss, which is a benefit when compared to other treatment options, like electroconvulsive therapy. The length of a session is dependent on which type of stimulation is being used but should last less than 30 minutes. With TMS, you should be able to return to your day-to-day activities after receiving treatment.
Transcranial Magnetic Stimulation Statistics in the United States
Who Should Avoid TMS?
Individuals with certain medical conditions, or implanted medical devices, may not be eligible for TMS. This includes those who have people with pacemakers, implanted defibrillators, metal aneurysm clips or coils, stents, bullet fragments, and other metallic implants. Having metal in other areas of your body can interfere with how your body responds to the stimulation.
Additionally, individuals who have a history of seizures or epilepsy, or those who have conditions that may increase the risk of seizures, may not be good candidates for TMS. You should still share your interest in TMS with your healthcare provider and discuss potential risks before considering TMS. Pregnant women and individuals with severe psychiatric conditions, including uncontrolled bipolar disorder or psychosis, may also need to avoid TMS or proceed with caution. Always consult a healthcare professional to determine if medical procedures are an appropriate treatment option for you and your body.
More Information About Blue Cross Blue Shield (BCBS) Health Insurance Coverage for Depression
Blue Cross Blue Shield (BCBS) typically provides treatment coverage for their members who are struggling with depressive symptoms and major depression disorder. Similar to other mental health conditions, depression is often individualized, meaning that your symptoms and impairments will be different compared to others with similar mental health conditions.
BCBS coverage for depression typically includes both inpatient and outpatient treatment options including clinical stabilization services, inpatient psychiatric care, partial hospitalization programming (PHP), intensive outpatient programming (IOP), and general outpatient care. Many find that their depression symptoms wax and wane over time, which is why depression treatment options are available in a variety of intensities and frequencies. BCBS insurance plans often include behavioral health treatment options, which include both mental health and substance use disorder treatment, meaning that you should be able to access the care and support you need if you feel as though your depressive symptoms are becoming too much to cope with on your own.
Does Blue Cross Blue Shield Cover TMS Treatment?
If you’re wondering, does Blue Cross Blue Shield cover TMS, we’re happy to share that they do often cover TMS treatment. It is important to note that the extent of your coverage can vary based on the details of your policy. TMS is often covered for those with treatment-resistant mental health conditions who have not responded to other treatments.
Your coverage for TMS may require prior authorization and have other requirements. As an example, BCBS may ask for you to show that you have tried using other therapeutic options and that they have not effectively reduced your symptoms. Your plan may have out-of-pocket costs in the form of deductibles, copayments, and premiums. To learn more about your coverage options for Blue Cross Blue Shield TMS centers, we encourage you to complete our online verification form and speak with an Admissions counselor by dialing (866) 461-4474 today!
BCBS Coverage for Types of Mental Health Disorders Treated with TMS
BCBS often provides coverage for TMS when being used to treat various mental health conditions that have been resistant to other treatment options, and in situations where individuals experience adverse health effects to other treatment options. There are differences in the number of TMS sessions needed to effectively reduce your symptoms, which can affect the overall cost of treatment.
BCBS Coverage for TMS Program for Treating Major Depressive Disorder (MDD)
BCBS Coverage for TMS Program for Treating Obsessive-Compulsive Disorder (OCD)
BCBS Coverage for TMS Program for Treating Bipolar Disorder
BCBS Coverage for TMS Program for treating Post-Traumatic Stress Disorder (PTSD)
BCBS Coverage for TMS Program for Treating Borderline Personality Disorder (BPD)
TMS Treatment Centers That Takes BCBS Near Me
The Harmony Health Group is a leading behavioral health treatment provider with multiple locations along the East Coast that are in network with BCBS, including our TMS treatment options. We encourage you to contact our Admission Counselors for guidance and assistance during the admission process, including navigating the logistics of traveling from out of state and finding comfortable housing.
Harmony Health Group TMS Treatment Centers in Florida (FL)
Harmony Health Group TMS Treatment Centers in Massachusetts (MA)
Harmony Health Group TMS Treatment Centers in North Carolina (NC)
Harmony Health Group TMS Treatment Centers in New Jersey (NJ)
Harmony Health Group TMS Treatment Centers in Tennessee (TN)
Harmony offers a multitude of locations up and down the East Coast for behavioral health services. Call us to learn about our facilities and treatment options.
How Much Do Transcranial Magnetic Stimulation Therapy Programs Cost With Blue Cross Blue Shield (BCBS) Health Insurance?
If you’re wondering, does Blue Cross Blue Shield covers TMS treatment, then you’ve come to the right place! BCBS plans often provide coverage for TMS treatments, for qualifying individuals. This typically means that you have tried other treatment options, such as psychotherapy and various medications, that are known to effectively treat the mental health condition you’re living with.
It is important to note that the coverage you receive from BCBS is dependent on your plan, as they have several customizable plan options that can change your out-of-pocket expenses. Because of this, it is challenging to provide you with an estimate of your expenses without knowing more about your insurance plan. If you are interested in TMS treatment options and would like to learn more about your TMS coverage with BCBS, we encourage you to contact our facility directly by dialing (866) 461-4474. Our Admissions Counselors can work with you to verify your health insurance so that you’ll have a better idea of what your out-of-pocket expenses would be for TMS treatment. This also gives you an opportunity to ask specific questions you may have about the treatment options available with the Harmony Addiction and Recovery Group.
How Much Does TMS Cost Without Blue Cross Blue Shield Insurance Coverage?
The total cost of your TMS treatment can vary based on the care that you receive. The length of time that you engage in treatment is dependent on your response to treatment and the reduction of symptoms. The cost of TMS sessions tends to range between $300 and $500, with an end total ranging between $6,000 to $12,000.
We understand that the cost of mental health treatment can be a barrier for many, so we encourage you to call (866) 461-4474 to speak with an Admission Counselor about available financial assistance for mental health treatment, including TMS payment plans, or sliding scale fees for TMS treatment.
What are the Average Out of Pocket Costs for TMS Therapy?
The average out-of-pocket costs for TMS will depend on several factors including the use of health insurance, details of your insurance coverage, the specific treatment center you choose, and the location of the treatment facility. Typically, the cost per TMS session ranges from $300 to $500, meaning that the total cost can range from $6,000 to $12,000.
Insurance coverage can significantly reduce these out-of-pocket expenses, making TMS an affordable option for those who have not responded to other treatment options. Many insurance plans, including Medicare and commercial insurers like Blue Cross Blue Shield, offer coverage for TMS. It is important to note that your insurance may need prior authorization for TMS before you engage in treatment. For a more detailed explanation of what your out-of-pocket costs for TMS would be, we encourage you to contact the Harmony Health Group by calling (866)461-4474 or completing our online verification form today.
What Determines the Cost of a Transcranial Magnetic Stimulation Therapy Program?
We’ve mentioned that there are a few factors that can influence the cost of TMS treatment, so let’s take a few moments to break this down, so you have a better understanding of where the costs of treatment as you search for “TMS near me that accepts Blue Cross Blue Shield” on an online search engine:
- Severity and Type of Condition: The specific mental health condition that you are experiencing, as well as its severity, can influence the overall cost of treatment. More severe or complex cases may require longer or more intensive treatment, which would likely increase the total treatment cost.
- Program Duration: The length of the TMS treatment program is a major cost factor. In many cases, treatment typically involves 20 to 30 sessions over the course of several weeks, but some individuals may require additional sessions, extending the duration and cost.
- Intensity of Treatment: The frequency and intensity of the TMS sessions can also impact your expected costs. Some treatment plans might have sessions closer together, while others might space out treatments over a longer period.
- Medical Services and Staff Expertise: The qualifications and experience of the medical staff administering the TMS treatment can affect costs as well. Clinics with highly specialized professionals, or those offering comprehensive care, may charge more for their service compared to other treatment providers.
- Facility Amenities and Accommodations: Having access to luxury amenities or accommodations can significantly influence costs. High-end clinics offering luxurious accommodations, and additional therapeutic services, tend to charge higher fees.
- Location: The geographic location of the treatment facility can also impact costs. Treatment facilities located in urban areas may have higher prices compared to those in rural, or more affordable areas.
- Insurance Coverage: Finally, the extent of your insurance coverage has a significant role in determining your out-of-pocket costs. While many insurance plans cover TMS, you may still be responsible for copayments, deductibles, and any non-covered portions of the treatment.
How To Check Blue Cross Blue Shield Coverage Levels for TMS?
To check your Blue Cross Blue Shield mental health therapy and treatment coverage for TMS, you can review insurance policy documents, specifically for covered services, exclusions, and necessary pre-authorizations. These documents can be found on your member portal, or you can request a hard copy directly from BCBS. You can contact member services to speak with a representative directly.
Another option is to contact your chosen TMS provider directly. As an example, the Harmony Health Group has an online verification form that you can complete to have assistance learning about the details of your plan. Our Admission Counselors have worked with BCBS frequently, and are familiar with their authorization process. If you’re ready to take a step towards experiencing the benefits that TMS can bring to your life, dial (866) 461-4474 to get started today!
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How To Have BCBS Pay For TMS Treatment?
The first step to having your treatment paid for by insurance is to verify your coverage to ensure that this is an option for you. You will want to ask if you are required to obtain a prior authorization too. Once your insurance has been verified, you can work with your TMS treatment facility to move through their admission process.
In most cases, your treatment provider will submit medical claims directly to BCBS on your behalf. This means that it is one less thing for you to worry about. Your treatment provider will provide BCBS with the documentation required to show that TMS is a medical necessity based on your symptoms and unintended resistance to other treatment approaches. In the instance that you need treatment longer than the time of your original authorization, your treatment provider will contact BCBS about a new authorization with extended dates. As you participate in treatment, your treatment provider will submit claims to BCBS on your behalf. Depending on the treatment facility, you may be asked to pay for your copayment at the time of service.
How Many Times Will BCBS Pay For TMS Treatment?
It is challenging to say how many sessions BCBS will cover for TMS treatment because they tend to offer coverage based on your needs at the time of service, which means that the number of sessions recommended by your medical professional are often honored, to promote effective and comprehensive treatment.
If additional TMS sessions are required beyond the scope of your initial authorization, further pre-authorization may be necessary. This is something that your treatment provider typically tracks, to ensure that you are staying within the limits of your insurance plan. We understand that you may have specific questions about your coverage for TMS treatment, or steps you need to take for prior authorization, which is a good thing! We encourage you to ask questions so that you can make informed decisions about your care. To speak with a Harmony Health Group Admissions Counselor, we encourage you to dial (866) 461-4474 today!
Related BCBS Coverage Articles
TMS Statistics and Information in the United States
- Research has indicated that of 137 patients, 29.3% responded to TMS treatment and that an estimated 18.6% achieved remission from major depression symptoms.
- One study found that TMS was a great augmenting approach for bipolar depression with psychotherapy, with success rates of 66% and 56% for two different research groups
- Approximately 33% of individuals who were treatment resistant that engaged in TMS treatment achieved remission in one study
- Individuals who receive TMS may still experience symptoms associated with their mental health condition at a later point, as mood disorders are associated with a high recurrence rate
- Major depressive disorder is the most responsive mental health disorder for TMS
- PTSD has been found to benefit the least from TMS when compared to other mental health disorders
- Research has found that there was a correlation between the effects of TMS and the individual’s age
Resources
- Bolu, A., I. Gundogmus, M. Aydin, D. Fadiloglu, Y. Erken, and O. Uzun. “Ten Years’ Data of Transcranial Magnetic Stimulation (TMS): A Naturalistic, Observational Study Outcome in Clinical Practice.” Psychiatry Research, May 9, 2021. https://www.sciencedirect.com/science/article/abs/pii/S0165178121002833.
- Nunez, Kirsten. “TMS Therapy: What It Treats, Benefits, Side Effects, and Costs.” Healthline, January 20, 2021. https://www.healthline.com/health/tms-therapy#costs.
- Somani, Aditya, and Sujita Kumar Kar. “Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far.” General psychiatry vol. 32,4 e100074. 12 Aug. 2019, doi:10.1136/gpsych-2019-100074
- “Transcranial Magnetic Stimulation.” Mayo Clinic, April 7, 2023. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
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