April 11, 2025
We routinely review our coverage, reimbursement, and administrative policies for potential updates. In that review, we take into consideration one or more of the following: Evidence-based medicine, professional society recommendations, Centers for Medicare & Medicaid Services guidance, industry standards, and our other existing policies.
As the result of a recent review, the Transcranial Magnetic Stimulation (EN0383) behavioral coverage policy was updated to include transcranial magnetic stimulation (TMS) for the treatment of major depressive disorder in adolescents aged 15–17. Initial and repeat regimens of TMS will be considered medically necessary for these patients when the criteria under the coverage policy is met.
This update is effective for dates of service on or after March 31, 2025.
Additional information
For more information about our policy updates, visit our Policy Updates web page or call Provider Services at 800.926.2273.
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