Medi-Cal TMS Therapy: Treatment-Resistant Depression Options
If you're on Medi-Cal and struggling with depression that hasn't improved with medication or therapy, you may qualify for TMS treatment at low or no cost to you. TMS uses magnetic pulses to stimulate brain areas involved in depression, offering hope when traditional methods have failed.
TAKE THE FIRST STEP TODAY
TMS Covered by Major Insurance Companies
RESPONSE RATES
TMS Versus Medication
NEUROPLASTICITY
Brain Activity Increased with TMS
Proudly Serving San Diego Carlsbad Encinitas Oceanside San Marcos Vista
Break free from depression
Our team is here to guide you through a personalized journey to reclaim your mental health and regain control of your life.
-
TMS Treatment Now Covered
by Medi-Cal in California -
What Is TMS?
-
Who Qualifies for TMS
Coverage Through Medi-Cal? -
How TMS Works
-
Benefits of TMS Treatment
-
TMS vs. Traditional
Depression Treatments -
Start TMS Therapy with
Medi-Cal: Here's How -
Locations Served
-
Medi-Cal TMS Treatment With
Sollus Health -
Sources:
TMS costs vary by provider and insurance plan. Find out what patients in your area are paying and find ways to reduce your expenses.
TMS Treatment Now Covered by Medi-Cal in California
Starting August 1, 2024, Medi-Cal began covering TMS treatment for adults with major depressive disorder (MDD) who meet eligibility criteria (Medical Device Network, 2024; California TMS Clinics, 2024). This coverage makes TMS accessible to Medi-Cal patients at no out-of-pocket cost for qualifying sessions. The National Health Law Program confirms that TMS is now recognized as an evidence-based treatment covered under the Medi-Cal program for individuals with treatment-resistant depression (National Health Law Program, 2024).
What Is TMS?
Transcranial magnetic stimulation delivers targeted magnetic pulses to specific brain regions responsible for mood regulation and emotional processing. This FDA-approved treatment works through:
- Non-Invasive Procedure: Stimulates neural activity in the prefrontal cortex without requiring anesthesia or surgical procedures
- Outpatient Treatment: Patients remain awake and alert during sessions
- Comfortable Experience: Experience only mild tapping sensations at the treatment site
- Precise Targeting: Magnetic coils generate precise electromagnetic fields to specific brain areas
Not sure about your insurance coverage for TMS? Learn about different insurance options and what requirements you may need to meet for TMS treatment coverage.
Who Qualifies for TMS Coverage Through Medi-Cal?
Medi-Cal covers TMS for adult patients who meet specific clinical criteria and have documented treatment failures with conventional approaches. Patients must demonstrate inadequate response to multiple antidepressant medications and psychotherapy interventions before qualifying for coverage (National Health Law Program, 2024). Medical documentation must support the diagnosis of mental health disorders with treatment-resistant characteristics:
- Prior Authorization: Must be completed before beginning treatment to ensure insurance coverage throughout the full protocol
- Treatment Protocol: Complete coverage spanning four to six weeks of daily sessions
How TMS Works
TMS works by using magnetic fields to stimulate specific areas of the brain that control mood and emotions. The magnetic pulses activate underactive brain regions commonly seen in depression, helping to restore normal brain function. Over time, repeated treatments allow the brain to form new, healthier connections that lead to lasting improvement in depression symptoms.
Benefits of TMS Treatment
TMS therapy has clear advantages over traditional psychiatric medications for patients with treatment-resistant depression:
- No Systemic Side Effects: Avoids weight gain, sexual dysfunction, and cognitive impairment commonly associated with antidepressants
- Zero Recovery Time: Patients can maintain normal daily activities immediately following each session
- Targeted Treatment: Precise stimulation of specific brain regions while preserving normal function in unaffected areas
- Outpatient Convenience: Treatment fits easily into daily schedules without disruption
TMS vs. Traditional Depression Treatments
Magnetic field stimulation provides localized brain treatment that works differently from oral medications circulating throughout the body (Mayo Clinic, 2023). TMS treatment shows meaningful improvement within 4-6 weeks, with many patients beginning to respond by the fourth week of treatment (Clinical TMS Society, 2016; Psychiatric News, 2008). The approach offers targeted brain stimulation without concerns about drug interactions or long-term medication dependency, allowing patients to continue their normal activities immediately after each session (VA Montana Healthcare, 2024).
Start TMS Therapy with Medi-Cal: Here's How
Accessing covered treatment involves a few steps to verify eligibility and obtain necessary approvals. Patients must work with qualified providers who accept Medi-Cal and have experience with prior authorization procedures:
Step 1: Schedule Your Free Consultation
Initial consultations allow psychiatric professionals to review your medical history, assess current symptoms, and determine if TMS is right for you. These evaluations document your previous treatment experiences and establish that TMS treatment is medically appropriate. The assessment covers your medication history, treatment experiences, and current depression symptoms.
Step 2: Eligibility & Insurance Approval
Prior authorization requires submission of detailed clinical documentation supporting the medical necessity for magnetic stimulation treatment:
- Documentation Review: Medi-Cal reviews treatment history and coverage criteria
- Processing Timeline: Approval process typically takes weeks to complete
- Provider Support: Providers work directly with insurance representatives to navigate authorization requirements
- Follow-Up Requests: Staff address any additional documentation requests from Medi-Cal
Step 3: Begin Treatment
Once approval is obtained, you can start your TMS treatment following a structured schedule of daily sessions over four to six weeks. Each session lasts 20 to 40 minutes, allowing you to immediately return to your normal activities. Your treatment team monitors your progress and personalizes your care based on how you respond to treatment.
Locations Served
Treatment services are available to residents throughout San Diego County, including Carlsbad, Oceanside, Encinitas, San Marcos, and Vista. The convenient location provides accessible care for patients traveling from throughout the region. Ample parking and comfortable facilities accommodate patients during their treatment schedules.
Medi-Cal TMS Treatment With
Sollus Health
Medi-Cal patients can receive covered TMS therapy through our Carlsbad and Oceanside clinics. Call 619-649-6658 to schedule your Medi-Cal TMS treatment consultation.
Sources:
- California TMS Clinics. TMS Now Covered by Medi-Cal. 2024.
- Clinical TMS Society. Consensus Review and Treatment Recommendations for TMS Treatment for Major Depressive Disorder. March 2016.
- Mayo Clinic. Transcranial magnetic stimulation. April 2023.
- Medical Device Network. TMS in California will have Medicaid coverage for major depressive disorder patients. July 11, 2024.
- National Health Law Program. Fact Sheet: Medi-Cal Coverage of Transcranial Magnetic Stimulation (TMS). October 2024.
- Psychiatric News. FDA Approves New Option to Treat Major Depression. 2008.
- VA Montana Healthcare. Transcranial Magnetic Stimulation (TMS) – Treatment for Depression. 2024.
COMPASSION. HOPE. ACTION
Conditions We Treat
Sollus Health offers effective, non-invasive treatment for conditions like depression, OCD, PTSD, and anxiety.
YOUR QUESTIONS ANSWERED
Frequently Asked Questions
Can't find what you're looking for? Get in touch with our team and we will gladly help out.
TMS is covered by Medi-Cal for adults with treatment-resistant depression who meet specific requirements. Coverage includes the full treatment course, but you need prior authorization before starting treatment.
Medi-Cal covers TMS treatment in California when other depression treatments haven't worked. You can receive this treatment at qualified facilities that accept Medi-Cal and offer TMS services.
To get TMS covered by insurance, your doctor submits documentation showing you have treatment-resistant depression and haven't improved with medications or treatment. The insurance company reviews this information and approves coverage if you meet its requirements.
TAKE THE FIRST STEP TODAY
A Simple Process to Begin Your TMS Journey
Take the first step toward lasting relief from depression with TMS therapy, a non-invasive, medication-free treatment designed to restore your well-being.
Break free from depression
Our team is here to guide you through a personalized journey to reclaim your mental health and regain control of your life.
BREAKTHROUGH TECHNOLOGY
Latest News and TMS Innovation
Discover the latest breakthroughs in TMS technology. Our innovative advancements enhance precision and effectiveness, bringing hope to more patients in San Diego.