Widespread Insurance Coverage for NeuroStar TMS Therapy®

Over 273 million patients have insurance policies that cover NeuroStar TMS Therapy through their health plans.4

Due to its innovative treatment and proven efficacy, NeuroStar TMS Therapy may be covered by your insurance health plan. Many insurance companies have established medical coverage policies for NeuroStar TMS Therapy. Please refer to this page and check back often as coverage may change and additional plans may be added.

Below is a list of the insurance companies and applicable States that cover TMS Therapy if a patient meets the medical necessary requirements and all other necessary guidelines are met. As coverage and payment can vary based upon the patient’s specific plan and guidelines, it is best to contact the insurance company to verify eligibility, benefits, and coverage for TMS Therapy. Not all medical coverage policies or Behavioral Health Carve-Out Plan’s Treatment Guidelines for TMS Therapy can be listed. For more information, please contact NeuroStar Reimbursement Support (NRS) at 1-877-622-2867 or reimbursementsupport@neuronetics.com

Commercial Plan Coverage

Anthem Blue Cross and Blue Shield

  • Covers California, Georgia, Nevada, Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, New Hampshire, Ohio, Virginia, Wisconsin, New York
  • Policy Number: #BEH.00002

Arkansas Blue Cross Blue Shield

  • Covers Arkansas
  • Policy Number: #2003055

Blue Cross Blue Shield of Alabama

  • Covers Alabama
  • Policy Number: #170

Blue Cross Blue Shield of Arizona

  • Covers Arizona
  • Policy Number: #N/A

Blue Cross Blue Shield of Florida

  • Covers Florida
  • Policy Number: #01-93875-18

Blue Cross Blue Shield of Hawaii (HMSA – Hawaii Medical Services Association)

  • Covers the Hawaiian Islands
  • Policy Number: MM.12.015

Blue Cross Blue Shield of Kansas

  • Covers Kansas
  • Policy Number: #N/A

Blue Cross Blue Shield of Louisiana

  • Covers Louisiana
  • Policy Number: #00121

Blue Cross Blue Shield of Massachusetts

  • Covers Massachusetts
  • Policy Number: #297

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan

  • Covers Michigan
  • Policy Number: #N/A
  • Blue Cross Blue Shield of Michigan Website

    Please Note: This link will only route you to the Medical Policy & Pre-Cert/Pre-Auth Router Home Page. To access the TMS Therapy Medical Coverage Policy, please continue with the following:

      1. For Select Category, choose General
      2. For Keyword/Phrase, enter Transcranial Magnetic Stimulation
      3. To access the policy, click on the PDF Icon

Blue Cross Blue Shield of Minnesota

  • Covers Minnesota
  • Policy Number: #X-14

Blue Cross Blue Shield of Nebraska

  • Covers Nebraska
  • Policy Number: #IV.67

Blue Cross Blue Shield of North Carolina

  • Covers North Carolina
  • Policy Number: #N/A
  • Please Note: Based upon the patient’s specific plan, BCBS of North Carolina follows the various Behavioral Health Carve-Out Plans’ medical necessity criteria and clinical guidelines. It is best to verify the patient’s plan’s coverage guidelines and specific Behavioral Health Carve-Out Plan by calling the number of the back of the patient’s insurance card.
    Magellan Behavioral Health Website (Please refer to TMS Treatment on page 137.)
    Beacon Health Options/Value Options Website (#7.102)

Blue Cross Blue Shield of Rhode Island

  • Covers Rhode Island, Massachusetts and New Hampshire
  • Policy Number: N/A

Blue Cross Blue Shield of Tennessee

  • Covers Tennessee
  • Policy Number: N/A

Blue Cross Blue Shield of Vermont

  • Covers Vermont
  • Policy Number: N/A
  • Medical Coverage Policy Link: N/A

Blue Cross Blue Shield of Western New York (Under Health Now)

  • Covers Western New York
  • Policy Number: N/A

Blue Cross Blue Shield Federal Employee Program

  • Covers Federal Employees
  • Policy Number: #2.01.50

Blue Cross of Idaho

  • Covers Idaho
  • Policy Number: #2.01.50

Blue Shield of California

  • Covers California
  • Policy Number: N/A

Blue Shield of Northeastern New York (Under Health Now)

  • Covers Northeastern New York
  • Policy Number: N/A

Capital Blue Cross

  • Covers Counties in Central Pennsylvania and Lehigh Valley
  • Policy Number: #N/A
  • Magellan Behavioral Health Website: (The TMS Therapy Medical Necessity Criteria Guidelines begin on page. 137)
    Please Note: Typically for this insurance company’s plans, Magellan Behavioral Health is the Behavioral/Mental Health Carve-Out company and manages these benefits.

Cigna

  • Covers Various States
  • Policy Number: #0383

Community Care of Oklahoma

  • Covers Oklahoma
  • Policy Number: #N/A

Emblem Health

  • Covers New York, Connecticut and New Jersey
  • Policy Number: # MG.MM.ME.43v3

Harvard Pilgrim

  • Covers Massachusetts
  • Policy Number: #N/A
  • Harvard Pilgrim Website
    Please Note: This link will only route you to the Network Matters TMS Coverage Main Page. To access the TMS Therapy Medical Coverage Policy, please click on the policy title, Transcranial Magnetic Stimulation Medical Review Criteria, located at the bottom of the page.

Health Care Service Corporation (HCSC) for BCBS of Illinois, Montana, New Mexico, Oklahoma, and Texas

  • Policy Number: #PSY301.015
  • BCBS of Illinois Website
  • BCBS of Montana Website
  • BCBS of New Mexico Website
  • BCBS of Oklahoma Website
  • BCBS of Texas Website
  • Please Note: If the Medical Coverage Policy cannot be accessed directly by the link below, this link will route you to Medical Policies Acknowledgement Page. To access the TMS Therapy Medical Coverage Policy, please continue with the following:

      Step 1. Disclaimer Page: Read and click on “I Accept”
      Step 2. Medical Policies Page: Click on Active Policies
      Step 3. All Active Policies Page: In the Search Box, enter Repetitive Transcranial Magnetic Stimulation

Health Net

  • Covers Arizona, California, Connecticut, Oregon, Washington
  • Policy Number: #NMP 508

Health New England

  • Covers Central and Western Massachusetts
  • Policy Number: N/A

Horizon Blue Cross Blue Shield of New Jersey

  • Covers New Jersey
  • Policy Number: #104

Independence Blue Cross

  • Covers Pennsylvania

Independent Health Association

  • Covers Upstate New York
  • Policy Number: #M20130418035
  • Independent Health Association Website
    Please Note: This link will only route you to the Policies Main Page. Only In Network Providers may access the medical coverage policy with this link and by using the provider’s log-in information (username and password). For all others, please contact Independent Health Association directly to obtain a copy of the medical coverage policy.

MVP Healthcare

  • Covers New York and Vermont
  • Policy Number: #7.102
  • Beacon Health Options/Value Options Website
    Please Note: Typically for this insurance company’s plans, Beacon Health Options/Value Options is the Behavioral/Mental Health Carve-Out company and manages these benefits.

Optima Behavioral Health

  • Covers Maryland, North Carolina, Virginia, West Virginia, Washington D.C.
  • Policy Number: N/A
  • Please contact Optima Behavioral Health directly to obtain a copy of the medical coverage policy.

Oxford Health Plans

*Please Note: Oxford Health Plans is a product of United Healthcare. For further information regarding the Medical Coverage Policy, please also refer to United Healthcare/OPTUM by United Behavioral Health listed below.

  • Covers Various States
  • Policy Number: #BEHAVIORAL 025.7 T2

Premera Blue Cross

  • Covers Washington and Alaska
  • Policy Number: #2.01.526

Priority Health

  • Covers Michigan and Other States
  • Policy Number: #91563-R1

Public Employees Insurance Agency (PEIA)

*Please Note: Depending on the plan type, PEIA plans are managed by either Health Smart or The Health Plan. Please verify the plan detail by contacting the Customer Service Department on the back of the patient’s insurance card.

  • Covers Ohio and West Virginia
  • Health Smart
    • Third Party Administrator (TPA) for the PEIA Self-Funded Plans
    • Policy Number: N/A
    • Please contact Health Smart directly for a copy of the TMS Coverage Guidelines.
  • The Health Plan
    • Manages certain plans for the PEIA (i.e., Fully Funded Plans, HMO Plans)
    • Policy Number: N/A
    • Follows Medicare’s Local Coverage Determination and medical necessity. Please refer to Palmetto GBA’s (Medicare Administrative Contractor for West Virginia) Local Coverage Determination: LCD #L34869

The Regence Group

  • Regency Blue Cross Blue Shield
    • Covers Oregon, Utah
  • Regency Blue Shield
    • Covers Idaho, Washington
  • Policy Number: #148

Tufts Health Plan

  • Covers Massachusetts
  • Policy Number: #2113347

United Healthcare/OPTUM by United Behavioral Health

*Please Note: Typically, Behavioral Health services and plans are managed by OPTUM by United Behavioral Health, but each plan’s benefits and coverage for TMS Therapy may vary. It is highly recommended that the TMS provider conduct a Benefits Investigation in order to verify if benefits and coverage are available for TMS Therapy based upon the specific plan.

UNITED HEALTHCARE

OPTUM by United Behavioral Health

Government Plan Coverage

MEDICARE PLANS

(Please Note: Most states have the same LCD#, but are listed separately by state.)

Cahaba

CGS Administrators, LLC

First Coast Service Options, Inc.

NGS (National Government Services)

Novitas

Palmetto GBA

WPS (Wisconsin Physicians Service Insurance Corporation)

MEDICAID PLANS

Medicaid of Vermont

Neuronetics is committed to assisting you and your patient in pursuing insurance coverage:

  • NeuroStar® Reimbursement Support (NRS) offers several services to assist you
  • Our Health Policy Team works with physician advocates and insurance companies to obtain coverage and medical policies.

Please Note: All reimbursement information provided by Neuronetics is for general guidance only. It does not represent a statement, promise, or guarantee by Neuronetics concerning levels of reimbursement, payment, or charge, if any. Coverage and payment for NeuroStar TMS Therapy is based on various factors, including but not limited to, medical necessity, the patient’s specific benefits plan, and individual insurance company’s policies and guidelines. It is the responsibility of the physician and the patient to be knowledgeable of the applicable guidelines.