37 Washington Square West Suite 1D

(C) Copyright 2017 by Shelly Menoloscino MD.  All Rights Reserved.

Diplomat of the American Board of Psychiatry and Neurology

Diplomat in Advanced Psychopharmacology

P (212) 647-9187

F (212) 243-1451

New York, NY 10011

Working with Your Insurance:

 

TMS therapy is covered by most major health insurance plans. The type of insurance plan that you have (i.e., private, with or without Out-of-Network benefits, Medicare plans, or Medicaid) will determine the level of your involvement with the insurance process. For those patients who meet TMS medical necessity criteria, as determined by our Medical Director during an in-office TMS consultation, we advocate for coverage, work diligently to obtain insurance, prior-authorization approval, submit and process claims, and provide ongoing support as insurance coverage issues arise. We do our best to make TMS an affordable and reasonable option for you.

 

If you have private insurance

(i.e., not a Medicare or Medicaid Plan) with Out-of-Network (OON) benefits:

  • The initial TMS consultation and

  • TMS services are generally covered. Dr. Menolascino is an OON provider.

 

If you have private insurance (i.e., not a Medicare or Medicaid Plan) without OON benefits (e.g., HMO or EPO plan):

  • The initial TMS consultation is not covered by insurance.

  • TMS services may be covered. We will need to contact your insurance to initiate a single-case agreement (SCA) at which point our office will pursue a prior-authorization. If granted, we will finalize negotiations to get your TMS covered.

 

If you have a Medicare Advantage or Medicare-HMO plan:

  • The initial TMS consultation is not covered by insurance.

  • TMS services may be covered. We will need to contact your insurance to initiate a single-case agreement [SCA link], at which point our office will pursue a prior-authorization. If granted, we will finalize negotiations to get your TMS covered.

 

If you have Medicaid or HMO-Medicaid as your primary insurance: TMS services are not covered.