As of 10-10-2020, here are the following requirements from the major insurance companies for coverage. We treat patients on a self-pay basis when they do not qualify for insurance coverage:
Each session of TMS is $400 but can be as low as $225 a session in packages for self-pay clients. If you prefer not to commit to a package, you can pay for each session individually at $400 a session. Once you have paid for the total package amount, you will automatically be converted to that package and receive the discounted rate. For example, let’s assume you did qEEG brain mapping ($2,995), and did 13 sessions of TMS at $400 each. This means you paid enough for a package of 36 TMS sessions, so your next 24 sessions are FEE.
You can start with a smaller package and upgrade to a larger one later by paying the difference to enjoy the benefit of lower package pricing.
It’s important to note that some services, such as qEEG Brain Mapping and cognitive skills tests, may not be covered by insurance or may be covered at a different rate. In these cases, you may owe for these services in addition to any co-pays or deductibles. However, these services are always included in our self-pay packages.
We believe that qEEG Brain Mapping is crucial to customize treatment and reduce the remote possibility of a seizure during treatment. If your insurance plan does not cover this procedure, we offer a self-pay discounted option of $995.00 instead of $2,995, provided you complete 36 TMS sessions. However, if for any reason you do not complete 36 sessions, regardless of the reason, you will lose this discount and be charged the full price.
You can start by paying for each service you need until you have decided on a course of therapy. For example, you can start with qEEG Brain mapping and test of attention and the initial evaluation. After reviewing the results, you can start with TMS, neurofeedback, or Auditory Training and apply what you have paid toward the package price (check to see what is included in each package). You can even start by paying for treatments on a per-session-bases for neurofeedback or TMS (according to our standard rates). You can then convert it to a package and apply what you have paid toward a package.
Service ( Many of these services are already included in the Treatment packages) | CPT Code | Fee |
---|---|---|
1) Psychiatric review for TMS candidacy (in-person or via Tele-Video), reviewing chart notes and history and test results (written report or signing forms such as Social Security or School Accommodations are not included and must be discussed before evaluation and will cost more) | CPT 99205 | $650.00 ( Included in most TMS packages) |
2) qEEG Brain Mapping with a written report by California Licensed Board Certified Neurologist (qEEG reveals how brain networks and regions are functioning and, compared to multiple databases, how they should be). If you need a diagnosis, you need to include at the very least, item 1 above. | CPT 95812, 95957 and 90889 | $2995.00 This price includes items 3 and 4 (IVA and CNS) qEEG is included in most of our TMS and Neurofeedback packages for self-pay patients. Patients paying for TMS through insurance will pay only $995.00 if they complete 36 TMS sessions. |
3) The Integrated Visual and Auditory (IVA) Continuous Performance Test of Attention and Mental Concentration measuring Auditory Attention, Visual Attention, Sustained Auditory Attention, Sustained Visual Attention, Auditory Elasticity, Visual Elasticity, Auditory Speed, Visual Speed, Auditory Impulse Control, Visual Impulse Control, Auditory Stamina, Visual Stamina, Fine Motor Hyperactivity, Auditory Comprehension, Visual Comprehension, Auditory Persistence, Visual Persistence, Auditory Sensory/Motor, Visual Sensory/Motor | CPT 96138 | $450.00 Included in certain TMS and Neurofeedback packages for self-paying patients. |
4) Computerized Neurocognitive Screening ( CNS ) Testing Visual memory, Verbal Memory, Reaction Time, Complex Attention, Simple Attention, Sustained Attention, Cognitive Flexibility, Processing Speed, Executive Function, Reasoning, Social Acuity, Working Memory, Motor Speed, Psychomotor Speed, Reaction Time and Neurocognition Index compared to the same-age population | CPT 96138 | $575.00 Included in certain TMS and Neurofeedback packages for self-paying patients. |
5) Wellness check (weekly while doing TMS) | CPT 99213 | $200.00 Included in certain TMS and Neurofeedback packages for self-paying patients. |
6) Motor Threshold to determine how much magnetic stimulation is required | CPT 90869 | $250.00 Included in certain TMS and Neurofeedback packages for self-paying patients. |
7) Initial Consultation meeting with our Center Director ( not a diagnostic evaluation) | CPT V68.20 | $195.00 Included in certain TMS and Neurofeedback packages for self-paying patients. |
8) TMS Session (please see discounted package below) | CPT 90868 | $400.00 ( Can be as low as $180 in TMS packages). This amount will be credited towards any TMS package, so once an amount equal to the price of a package has been paid, the balance of sessions in that package is free. |
9) Neurofeedback or tDCS Session (see discounted packages below) | CPT 90901 | $175.00 (Can cost as low as $75 in Neurofeedback Packages) |
10) Auditory Training per hour (see discounted packages below) | CPT 90901 | $175.00 (Can cost as low as $80 in Auditory packages) |
11) Auditory Processing Skills Assessment compared to similar age populations (includes CNS and IVA, items 3 and 4 above) | CPT 96138 | $995.0.00 Included in Auditory Training packages. |
12) ADHD Diagnosis (Includes services listed above 1,2,3,4, symptoms rating forms, and review of records) 13) Full Diagnostic Evaluation ( Suitable for ACT, SAT, LSAT, GMAT, Bar Exam, etc.) | Multiple Codes | $3,795.00 ( $2,500 applied towards certain Neurofeedback or TMS Packages) $5,500-$7,500 |
14) 504 School accommodations in accordance with Americans with Disabilities after diagnostic services. | Multiple Codes | $350.00 |
15) Forms including work leave of absence, short term-disability forms, or requests for modifications or accommodations (WE DO NOT COMPLETE ANY DOCUMENTS FOR LONG-TERM DISABILITY) | Multiple Codes | $500.00 |
To schedule an assessment, we ask that you reserve a 2-3 hour block of time, and we’ll schedule our staff accordingly. In order to reserve this time, we require a non-refundable deposit of $500, which will be applied towards the cost of your assessment.
Once we receive your forms, we’ll be in touch to give you a more precise estimate of the time required for your assessment. Please note that we do not offer refunds for any reason.
If you need to reschedule your appointment, you may do so up to two times with 48 hours advance notice. Any resulting credit will be valid for 364 days from the current date.
Brain Wellness Center offers integrative, comprehensive, compassionate care that results in long-term solutions for our clients.