TMS Is Now Covered by Medicaid in New York State

Neuronetics, Inc. announced that New York State Medicaid will begin covering TMS services for
adults diagnosed with major depressive disorder (MDD). The coverage will take effect October
1, 2025, for fee-for-service Medicaid members, and November 1, 2025, for those enrolled in
Medicaid Managed Care Plans. Coverage varies by state and requires prior authorization.
California has also expanded Medicaid coverage for TMS to treat Major Depressive Disorder
(MDD).

The following are some of the requirements to access these resources. Coverage requires
documentation of treatment-resistant depression MDD. To get diagnosed for Transcranial
Magnetic Stimulation (TMS), you must have a formal diagnosis of Major Depressive Disorder
(MDD) and typically failed to receive benefits from at least two to four antidepressant
medications. They must also have tried at least two different antidepressants from two classes
(SSRIs, SNRIs, or MAOIs) without seeing results positive enough to continue treatment, and
tolerable side effects, if any.

Medicaid is administered at the state level; while coverage is growing, it is not universal in
every state. While initial treatment courses are generally covered, coverage for maintenance
sessions may vary. This coverage does not currently include OCD (Obsessive-Compulsive
Disorder) in the state of New York. The following are some key exclusions.

− Metal/ferromagnetic implants. Any conductive or magnetic material in the head,
including aneurysm clips, cochlear implants, stents, shrapnel, bullets, or metallic
fragments near the treatment coil.− Medical devices. Pacemakers, implantable cardioverter defibrillators (ICD), vagus nerve
stimulators, or deep brain stimulators.
− Seizure disorders. A history of epilepsy or uncontrolled seizure disorder is a primary
contraindication.
− Neurological conditions. Recent stroke, severe brain injury, tumors, or increased
intracranial pressure.
− Substance abuse. Active, recent substance abuse (within 90 days).
− Other factors. Unstable psychiatric, medical, or cardiovascular conditions, pregnancy
(generally considered), and metallic ink tattoos on the face/neck.
− Provider. Approval requires prior authorization, where psychiatrists must submit clinical
documentation.

Treatment must be administered by a qualified psychiatrist with specialized training. A
psychiatrist must conduct a thorough, in-person, or video-based, evaluation to confirm your

eligibility, assessing your medical and psychiatric history, including ruling out the above
contraindications.

Neuronetics, Inc. is a medical technology company focused on designing, developing, and
marketing products that improve the quality of life for patients who suffer from neurohealth
disorders and the maker of NeuroStar® Advanced Therapy, the leading provider of Transcranial
Magnetic Simulation (TMS).

It is essential to contact your specific Medicaid plan or a local TMS provider to confirm
coverage, as policies can change. Talk to us about it by writing to us on our website or by calling
(585) 442-6960.