We accept both insurance and self-pay for TMS Treatments
Insurance covers TMS treatment for Major Depression ONLY when the following criteria are met:
1. Cognitive behavioral therapy has failed AND
2. Antidepressants and/or other mood stabilizing/stimulating medications have failed or side effects have proven too disruptive to a patient’s lifestyle or system
Treatment typically consists of 30-36 sessions performed 5 times per week over a 7-8 week period.
At this time we only accept Blue Cross Blue Shield PPO. Depending on the state and the plan, BCBS PPO Illinois has been relatively direct and fair with regard to covering TMS. After the initial consultation and if indicated, we will start a prior authorization process with your insurance company on your behalf. Prior authorization is NOT guaranteed and must be approved before we can begin insurance-covered treatment.
We will give you transparent pricing regarding information related to your plan’s co-pay, co-insurance, and deductible/out-of-pocket max.
If your plan covers out-of-network providers, we may be able to contract with your insurance to offer a lower rate, however your payment responsibility may be higher than our self-pay option.
Using insurance can limit our ability to participate in accelerated protocols as they are are not covered.
Self Pay Costs
The self-pay option is competitively priced and can be less costly than if using a high deductible insurance plan. Self-pay allows for leeway to use newer, proven, and better tolerated treatment protocols. These protocols may allow us to accelerate treatment to half the time that is normally required.
Full treatment course (36 sessions)
Paid in full : $4950
Paid Weekly ($750/week) : $5250
10 sessions ($175/session) : $1750
20 sessions ($165/session) : $3300
30 sessions ($155/session) : $4650
40 sessions ($145/session) : $5800
A La Carte
Single session : $215
Self-pay treatments or packages must be paid in advance, in full. For full treatment course paid weekly, payment must be made at the start of each week.
You have the option to choose your schedule* based on maximizing 2 out of following 3 factors:
Number of sessions / week
Number of weeks total
Length of Appointment
You live in or near Lincoln Park/Lakeview Chicago: Five days per week for 7 1/2 weeks. 30 minutes per appointment
You live over 30 minutes away: Once per week, for 7 weeks, 4 hours per appointment (5 sessions per appointment)
You are able to reduce your workload or are on vacation for a few weeks: Five days per week for 3 1/2 weeks, 90 minutes per appointment (double sessions)
*Customized scheduling for self-pay treatments only
What makes treatment this expensive?
The biggest cost factors are:
- Staff and providers. This includes time spent coordinating, providing daily evaluation and safety assurance, answering questions, insurance processing, being present and accommodating intra-sessionally, all time and cost spent associated with being registered and qualified (licensing, insurance, schooling), etc.
- The machine with all accessories. The machine and components have a lifespan, after which they have to be replaced. The machine itself is insured.
- Electricity to the machine and space in general
- Leasing of the space needed to house the machine, each machine requires a 10 x 15 space. This is in addition to the space needed to conduct evaluations.
- Smaller accessories: eg. disinfectant supplies, ear plugs, other normal office supplies
- Record-keeping and communication software and hardware
- Other intangible aspects such as time spent on being up-to-date with literature and best practices