Insurance & Costs

At the Brain Wellness Center we accept insurance only for the treatment of Medication-Resistant Depression using TMS only. For all other services, payment is required at the time of treatment.

Referral & Authorization

A referral is not required for TMS treatment. However, an initial evaluation by us is necessary to confirm if TMS is appropriate for you. If so, we will handle all paperwork and submit a prior authorization request to your health plan on your behalf.

Self-Pay TMS Options

Self-pay patients have the flexibility to complete up to 5 sessions per day, allowing the full 36-session course to be completed in as little as one week—compared to 1 session per day when using insurance.

As of 10-10-2020, insurance coverage requires:

  • Age 18+
  • Diagnosis of severe major depression
  • At least 6 weeks of weekly talk therapy
  • No history of seizures or epilepsy
  • No magnetic metal within 12″ of the head (implants/disk OK)
  • Tried required number of antidepressants (varies by insurer see below)

Insurance Requirements for TMS Coverage

Before TMS is approved, most insurance companies require you to try a certain number of antidepressant medications. Here’s a general guide based on your insurance provider:

  • Ages 15–17:
    • Must have tried and failed 2 antidepressant medications (any class)
  • Ages 18+:
    • Must have tried and failed 2 antidepressants from different classes

Augmentation:

  • Yes — TMS is covered along with medication and/or therapy, not as a standalone treatment

Ages 18+:

    • Must have tried and failed 2 antidepressants from different classes (for example, not both SSRIs)

Augmentation:

  • Yes — TMS is covered along with medication and/or therapy, not as a standalone treatment

Ages 18+:

  • must have trialed and failed psychotherapy and ECT (or documented reason why not).

Must have tried and failed 2 antidepressants from different classes (for example, not both SSRIs)

TMS Coverage for Depression (Ages 18+)

  • Must have failed at least 2 antidepressants from different medication classes
  • Must have trialed and failed psychotherapy and ECT (or documented reason why not).

TMS Coverage for OCD (Ages 18+):

  • Must have a DSM-defined OCD diagnosis
  • Failed 2 or more medications
  • Failed CBT or ERP therapy
  • Y-BOCS score required before and after treatment

TMS Coverage for Depression

  • Ages 15–17:
    • Must have tried and failed 2 antidepressants (any type)
  • Ages 18+:
    • Must have tried and failed 2 antidepressants from different classes (for example, not both SSRIs)

TMS Coverage for OCD

  • Requirements:
    • Must be 18 or older
    • Have a DSM-defined OCD diagnosis
    • Tried and failed 2 or more OCD medications
      • Taken for at least 8 weeks at full dose
      • Or stopped early due to side effects
    • Tried OCD-focused therapy without success
    • Must complete Y-BOCS assessments
      • One before and one after each round of TMS

Must try 1 antidepressant

Must try 2 antidepressants

We are not accepting Medicare patients at this time

TMS Coverage for Depression

  • Ages 15–17:
    • Must have tried and failed 2 antidepressant medications (any class)
  • Ages 18+:
    • Must have tried and failed 2 antidepressants from different classes

Augmentation:

  • Yes, must have trialed and failed psychotherapy and ECT (or documented reason why not).

Yes, must fail 2 medications from at least two different classes

Augmentation:

  • Yes, must have trialed and failed psychotherapy and ECT (or documented reason why not).
  • Ages 18+:
    • Must have tried and failed 2 antidepressants from different classes (for example, not both SSRIs)

Augmentation:

  • Yes, must have trialed and failed psychotherapy and ECT (or documented reason why not).

Must try 1 antidepressant

  • Ages 18+:
    • Must have tried and failed 2 antidepressants from different classes (for example, not both SSRIs)

Augmentation:

  • Yes, must have trialed and failed psychotherapy and ECT (or documented reason why not).
  • Ages 18+:
    • Must have tried and failed 2 antidepressants from different classes (for example, not both SSRIs)

Augmentation:

  • Yes, must have trialed and failed psychotherapy and ECT (or documented reason why not)

Coverage varies by county

Co-Pay Info:

  • TMS co-pays are usually $20–$75 per session (Total varies from $720 to $1,350).
  • We verify insurance and confirm your costs before treatment.
  • If your insurance does not cover qEEG Brain Mapping, you may opt for a discounted self-pay rate of $1500 (regularly $2,995) if you complete 36 TMS sessions. If the full course is not completed, the standard rate applies. This service is always included in our self-pay packages.
  • Some deductibles and out of pocket max may apply to these service depending on your insurance plan

TMS Packages

( Without Insurance )

$650.00 first session (includes mapping & power setting)

Additional Sessions $400.00, Lower Prices With Packages

CPT:90868

20 Sessions

$8,995
package info

Additional Sessions: $225

what’s included
  • Initial Evaluation Included
  • 1 qEEG Brain Map Included
  • Up to 2 Xpress qEEG Included

  • Up to 1 Motor Threshold Test Included
  • Up to 3 Wellness Visits Included
  • 1 IVA Test Included
  • 1 CNS Testing (Before & After) Included

Upgrade Option available within 14 days of finishing a smaller package.

Evaluation Credit for eval/brain map/IVA/CNS if package started within 30 days

Additional Sessions

$225 each (must be started within 30 days of completing this package)

Best Value Deal

50 Sessions

$12,995
package info

Additional Sessions: $225

what’s included
  • Initial Evaluation Included
  • 2 qEEG Brain Map Included

  • Up to 3 Xpress qEEG Included

  • Up to 6 Wellness Visits Included

  • Up to 3 Motor Threshold Test Included

  • 3 – IVA Test Included

  • 3 – CNS Tests (Before & After) Included

Evaluation Credit for eval/brain map/IVA/CNS if package started within 30 days.

Additional Sessions

$225 each (must be started within 30 days of completing this package)

36 Sessions

$10,995
package info

Additional Sessions: $225

what’s included
  • Initial Evaluation Included
  • 1 qEEG Brain Map Included
  • Up to 2 Xpress qEEG Included

  • Up to 2 Motor Threshold Test Included
  • Up to 3 Wellness Visits Included
  • 2 IVA Test Included
  • 2 CNS Tests (Before & After) Included

Upgrade Option available within 14 days of finishing a smaller package.

Evaluation Credit for eval/brain map/IVA/CNS if package started within 30 days

Additional Sessions

$225 each (must be started within 30 days of completing this package)

  • Most clients notice improvement between 15–25 sessions.
  • All optional services (IVA, CNS, qEEG, wellness visits) are included—no extra charge, no credit if unused.
  • You can upgrade to a larger package within 14 days by paying the difference.
  • If insurance approves treatment, you still qualify for TMS discounts (e.g., $1500 qEEG with 36 sessions).
  • Any insurance over-payments go toward your deductible/co-pays; the rest is refunded.

Neurofeedback Packages

(In-Home or In-Office, CPT:90901)

Session Cost: $175 per 50-minute session, Lower Prices With Packages
Includes in-office supervision, equipment setup, and online access for home sessions

20 Sessions

$3,995
what’s included
  • Initial Evaluation Included
  • 1 qEEG Brain Map Included
  • 2 IVA Tests Included (start & finish)

  • CNS Testing Not Included

  • 2 Months Online Access Included

Best Value Deal

65 Sessions

$6,995
what’s included
  • Initial Evaluation Included
  • 2 qEEG Brain Map Included

  • Up to 3 IVA Tests Included (start, mid, finish)

  • Up to 3 CNS Tests Included (start, mid, finish)

  • 5 Months Online Access Included

45 Sessions

$4,995
what’s included
  • Initial Evaluation Included
  • 1 qEEG Brain Map Included
  • 2 IVA Tests Included (start & finish)

  • 2 CNS Tests Included (start & finish)

  • 3 Months Online Access Included

  • All packages can be upgraded within 14 days of completion—just pay the difference.
  • Optional tests (qEEG, CNS, IVA) are included at no extra cost. No credit is given if skipped.
  • Credit for prior evaluations and tests applies if you begin a package within 30 days.
  • Neurofeedback Equipment: A $10 daily fee applies if equipment is not returned after your sessions are completed, unless you upgrade to a larger package.
  • Daily fees are waived for the following timeframes based on your package:
    • 20 sessions – 60 days
    • 45 sessions – 120 days
    • 65 sessions – 160 days
    • 95 sessions – 250 days
  • To avoid charges, equipment must be returned before your allotted time ends

Auditory Integration Training

(In-Home Or In-Office CPT: 90901)

Hybrid Berard & Tomatis Method | Includes Testing & Equipment Setup

Special Autism Pricing
  • Nonverbal autistic children pay for 120-hour package and receive 60 extra hours FREE.
  • qEEG testing used at start, 90 hours, and 180 hours. Additional qEEGs optional at added cost.
30 Hours

$3,995

What’s Included
  • 2 Audiometric Tests Included
  • 2 SCAN (APD Tests) Included

  • 2 TAPS (Auditory Skills) Included
  • qEEG Alternative Replaces Testing if Child Cannot Perform

Upgrade option within 14 days (add $450 if post-testing used)

60 Hours

$4,995

What’s Included
  • Up to 4 Audiometric Tests Included

  • 2 SCAN (APD Tests) Included

  • 2 TAPS (Auditory Skills) Included
  • 1 qEEG if needed

Upgrade option within 14 days (add $450 if post-testing used)

90 Hours

$5,995

What’s Included
  • Up to 6 Audiometric Tests Included

  • 2 SCAN (APD Tests) Included

  • 2 TAPS (Auditory Skills) Included
  • 2 qEEG if needed

Upgrade option within 14 days

120 Hours

$6,995

What’s Included
  • Up to 6 Audiometric Tests Included

  • 2 SCAN (APD Tests) Included

  • 2 TAPS (Auditory Skills) Included
  • 2 qEEG if needed

Upgrade option within 14 days (add $450 if post-testing used)

Most Popular

180 Hours

$8,995

What’s Included
  • Up to 6 Audiometric Tests Included

  • 3 SCAN (APD Tests) Included

  • 3 TAPS (Auditory Skills) Included

  • 3 qEEG if needed

Important Notes
  • Nonverbal autistic children pay for 120-hour package and receive 60 extra hours FREE.
  • qEEG testing used at start, 90 hours, and 180 hours. Additional qEEGs optional at added cost.
  • Training is done at home with Tomatis bone conduction headphones.
  • Equipment requires a $300 refundable deposit, returned if equipment is undamaged and sent back within 14 days of stopping.
  • All payments for evaluations and testing can be credited toward packages if started within 30 days.
  • Packages must be completed within 12 months. No credit is given for skipped assessments. 14 days
  • If a package is not completed, standard service fees apply and any remaining balance is refunded (discount is lost, but you won’t overpay).

CANCELLATION POLICY

  • Missed appointments (treatment/wellness): $150 fee if not canceled 24+ hrs in advance.
  • Assessments require a $500 non-refundable deposit. You may reschedule twice with 24 hrs notice.
  • 72hr refund
  • Assessment credit valid for 1 year.

IMPORTANT NOTES

  • No refunds or credits for unused tests.
  • Insurance rarely covers Neurofeedback, qEEG, or Auditory Training.
  • TMS may be covered for treatment-resistant major depression with prior authorization.
  • No insurance coverage for Auditory Training, Neurofeedback, or qEEG.
  • We provide a super bill possible reimbursement but we do not accept insurance