Insurance

Does insurance cover TMS therapy?

Initial Consultation

The initial in-person transcranial magnetic stimulation (TMS) therapy consultation may be covered by insurance but reimbursement will depend on your specific mental health insurance policy. Payment is due at the time of consultation at our Denver or Lakewood TMS clinic and we will furnish you a paid receipt that you can submit to your insurance carrier. This service is provided by Ted Wirecki, MD, PC and will be billed by Ted Wirecki, MD, PC.

Pre-authorization for mental health services

Most insurance companies require pre-authorization for covered mental health services including TMS therapy (if coverage is available). We strongly encourage you to contact your insurance carrier to inquire about any pre-authorization requirements. Please contact our Denver TMS clinic at 303-884-3867 if you have any questions regarding the information from your insurance carrier or if you need assistance with the pre-authorization process.

Payment of services covered by insurance

The TMS Center of Colorado, LLC is a network provider for the following insurance providers:

  • Anthem Health
  • Anthem Blue Cross and Blue Shield
  • United Healthcare/Optum
  • Cigna

Patients are required to pay all co-pays, co-insurance and balances on account at the time of service. TMS therapy is not covered under many insurance plans and the patient is responsible for payment for the therapy (see below regarding filing for insurance reimbursement).  We accept most forms of payment. Payment for TMS therapy should be made to TMS Center of Colorado, LLC.

Insurance coverage and reimbursement for Transcranial Magnetic Stimulation

Although some insurers do not cover TMS therapy at this time, some patients may want to bill their insurance carrier to be certain. We will furnish you with a paid receipt that you can submit for reimbursement. Alternatively, as a courtesy, we will submit a claim for TMS therapy to your insurance carrier on your behalf. Even if we do, you are still responsible for payment of TMS therapy charges at the time of your initial treatment, in accordance with our charges for self-pay patients, discussed above. If you want to appeal a denial of TMS services, your insurance carrier may require a letter of medical necessity and we will furnish this on request. Please be aware that our charge to insurance may differ from our charge for self-pay patients. In the few cases where TMS Centers of Colorado has a contract with your insurance carrier, we will bill your carrier in accordance with the terms of the contract.

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