Working with Your Insurance:
TMS therapy is covered by most major health insurance plans. For those patients who meet TMS medical necessity criteria, we work diligently to obtain insurance coverage, 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 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 (not a Medicare or Medicaid Plan) without Out-of-Network OON benefits (for example, 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. Most insurances will grant a single-case agreement.
If you have Medicaid or HMO-Medicaid as your primary insurance: TMS services are not covered at this time.