Although TMS shows promise for treating symptoms of TBI and concussion, Carelon currently covers TMS treatment for depression only—not for TBI or concussion. However, patients with both TBI and a diagnosis of depression may still qualify.
Medi-Cal currently provides coverage for TMS only when used to treat Major Depressive Disorder. TMS treatment for TBI or concussion is not covered unless the patient also has a qualifying depression diagnosis.
Covered California plans typically only authorize TMS for depression. TBI patients may be eligible if depression is also diagnosed and documented.
Health Net limits TMS coverage to depression-related cases. Coverage for TBI is not approved unless depression is present.
