TMS CPT Codes

In most cases insurance will cover a portion of TMS treatment for depression after a patient has failed to respond to 3 rounds of medication. See TMS CPT codes below.

CPT Code 90867

Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management.

  • Should be reported only once in a treatment course
  • Should not be reported with CPT Codes 90868, 90869, 95860-95870, 95928, 95929, 95939

CPT Code 90868

Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session.

CPT Code 90869

Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management.

  • Should not be reported with CPT Codes 90867, 90868, 95860-95870, 95928, 95929, 95939

Disclaimer: CloudTMS provides some general information about billing and coding that may be applicable to services or procedures performed with the aid of the CloudTMS device. However, CloudTMS is an equipment company and, as such, does not participate in its customers’ billing and does not guarantee that procedures performed with the aid of the CloudTMS device will be covered or reimbursed by any governmental or private payors. Providers must use their own judgment when deciding whether or how to bill for services and procedures provided to a patient. CloudTMS recommends that providers contact insurance carriers directly to inquire about their coding and reimbursement policies for services or procedures performed with the aid of the CloudTMS device.

For Medicare coverage and reimbursement information for specific localities, providers may be able to find useful information through the on-line coding resources provided by the American Medical Association ("AMA"), provided at:
https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do

Providers can also obtain information directly from the Centers for Medicare and Medicaid Services ("CMS"), including the Medicare Claims Processing Manual, which is available at:
https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx

For Private insurance carriers, the policies of individual carriers may differ significantly from Medicare and providers should contact their insurance carriers to obtain relevant guidelines and information.

It is the sole responsibility of the provider to ensure that it is in compliance with all applicable laws, regulations, coverage decisions, policies, and contractual obligations that may govern the reimbursement of services and procedures performed with the aid of the CloudTMS device. CloudTMS makes no promise that services or procedures performed with the aid of the CloudTMS device can be billed to any particular payor or that they will be reimbursed by any payor.