Does Insurance Cover TMS? What Actually Matters in Washington
Does Insurance cover TMS in Washington?
In most cases, yes.
Many major insurance providers in Washington cover TMS for treatment-resistant depression, including:
- Premera Blue Cross
- Regence BlueShield
- Aetna
- Cigna
- UnitedHealthcare
- Kaiser (coverage varies by plan)
Coverage policies differ by plan, but TMS is widely recognized as an evidence-based, FDA-approved treatment.

What Insurance Companies Actually Care About
Insurance approval isn’t random - it’s based on clear criteria. The most common requirements include:
1. Diagnosis of Major Depressive Disorder (MDD)
Most plans require a formal diagnosis of moderate to severe depression.
2. Prior Treatment History
Typically, insurers want documentation that you’ve tried:
- 2–4 antidepressant medications, and/or
- Psychotherapy
These treatments don’t have to be recent — your history matters.
3. Medical Necessity
Your provider must demonstrate that TMS is medically appropriate based on:
- Ongoing symptoms
- Medication intolerance or limited response
- Functional impairment
At
Creative Wellness TMS, this documentation is part of your evaluation.
What TMS Usually Costs With Insurance
With insurance approval, most patients in Washington pay:
- Copays or coinsurance, similar to other outpatient treatments
- Sometimes, there is a deductible, depending on your plan
For many patients, this results in a fraction of the self-pay cost.
Without insurance, a full TMS course can cost several thousand dollars, which is why verifying benefits is so important.
What If Insurance Doesn’t Approve TMS Right Away?
This happens - and it doesn’t mean “no” forever.
Common reasons for initial denial include:
- Missing documentation
- Insufficient treatment history on file
- Clerical or coding issues
Our team regularly assists with:
- Insurance verification
- Prior authorizations
- Appeals when appropriate
Many approvals come through after clarification or appeal.

Interested in learning more?
Schedule a consultation to see if TMS could be right for you.
Visit our contact page or call 253-900-1605 to speak with our team.
Does Medicare Cover TMS in Washington?
Yes -
Medicare does cover TMS for treatment-resistant depression when medical criteria are met.
Coverage details vary, but TMS is recognized under Medicare guidelines as a valid treatment option.
Does Insurance Cover TMS for Anxiety or Other Conditions?
Currently, insurance coverage is most consistent for:
- Major Depressive Disorder
Coverage for anxiety, OCD, PTSD, or other conditions may:
- Require a depression diagnosis
- Be considered on a case-by-case basis
- Be available through self-pay options
Our providers can help determine the most appropriate path.
What Actually Matters Most
When it comes to insurance and TMS, these factors matter more than anything else:
✔ A thorough evaluation
✔ Accurate documentation
✔ Clear treatment history
✔ A clinic experienced with insurance navigation
That’s where many patients get stuck - and where we help.
We Help You Navigate Insurance - Before You Commit
At Creative Wellness TMS, we believe cost shouldn’t be a mystery or a barrier.
We offer:
- Complimentary insurance benefit verification
- Transparent cost discussions
- Support through prior authorization and appeals
- Clear answers before treatment begins
Schedule a consultation today to learn whether TMS is covered under your Washington insurance plan and what your actual out-of-pocket cost may be.


















