Insurance Criteria for TMS

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TMS Criteria for Depression AND OCD with Cigna insurance: 

• Diagnosis of Major Depressive Disorder  OR OCD without psychosis 
• NO active psychotic symptoms
• Failed 2 or more antidepressants from different classes
•  Is NOT Actively suicidal with plan and intent 
•  Minimal improvement with psychotherapy 
• 18+
• Cigna TMS guidelines 

TMS Criteria for Depression with Optum/ United insurance: 

• Diagnosis of Major Depressive Disorder without psychosis 
• NO active psychotic symptoms
• Failed 2 or more antidepressants from different classes
•  Is NOT Actively suicidal with plan and intent 
•  Minimal improvement with psychotherapy 
• 18+
• Optum TMS Guidelines

Of note, Optum requires single case agreements for TMS for OCD 

TMS Criteria for Depression AND OCD with TriCare insurance: 

• Diagnosis of Major Depressive Disorder OR OCD without psychosis 
• NO active psychotic symptoms
• Failed 2 or more antidepressants from different classes
•  Is NOT Actively suicidal with plan and intent 
•  Minimal improvement with psychotherapy 
• 18+ 
• TriCare TMS guidelines

Of note, TriCare requires single case agreements for eligibility for both OCD & 

TMS Criteria for Depression AND OCD with BCBS insurance: 

• Diagnosis of Major Depressive Disorder OR OCD without psychosis 
• NO active psychotic symptoms
• Failed 2 or more antidepressants from different classes
•  Is NOT Actively suicidal with plan and intent 
•  Minimal improvement with psychotherapy 
• 18+
• BCBC TMS Request Form 

TMS Criteria for Depression Aetna insurance: 

• Diagnosis of Major Depressive Disorder without psychosis 
• NO active psychotic symptoms
• Failed 2 or more antidepressants from different classes
•  Is NOT Actively suicidal with plan and intent 
•  Minimal improvement with psychotherapy 
• 15+
• Aetna TMS Guidelines 

Of note, Aetna requires single case agreements for TMS for OCD