Aetna Coverage for TMS Therapy | Florida TMS Clinic
Aetna • Tampa & Wesley Chapel

Aetna Coverage for TMS Therapy

Florida TMS Clinic is an in-network provider for Aetna. We verify your benefits, manage pre-authorization, and deliver FDA-cleared TMS for depression — with accessible scheduling and measurement-based care.

📞 Call (813) 867-2378 📅 Request an Aetna coverage check Pre-authorization handled for you

In-network, outcomes-focused

TMS that fits your Aetna plan — and your life

We’re an experienced TMS center serving Tampa and Wesley Chapel with a full program: psychiatric evaluation, measurement-based care, FDA-cleared protocols, and collaborative follow-up with your therapist or PCP. Our team submits the authorization packet to Aetna, tracks your progress with validated scales, and keeps you and your care team informed.

  • In-network for Aetna
  • Measurement-based care(PHQ-9, HAM-D, MADRS, BDI) to document improvement
  • Clear expectations on session count, augmentation requirement, retreatment timing
  • Flexible scheduling and quick turnarounds on pre-auth

Aetna TMS Coverage: Eligibility & What’s Included

Aetna deems TMS medically necessary for major depressive disorder when all of the following are met.

Eligibility checklist (MDD)

  • Age: ≥15 years
  • Diagnosis: Severe unipolar MDD without psychosis, confirmed by a psychiatrist and documented on a validated rating scale (baseline and serial tracking)
  • Medication history:
    • Two antidepressant trials from different classes, each ≥8 weeks at maximally tolerated labeled dose
    • One augmentation trial alongside the primary antidepressant, ≥8 weeks, adequate dose (if an antidepressant is used for augmentation, it must be a different class )
  • Device & supervision: FDA-cleared TMS device; treatment ordered/overseen by a psychiatrist with proper on-site supervision
  • No contraindications per policy (e.g., certain implants/devices, recent substance abuse, active suicidality, specific neurologic conditions)

We verify your eligibility and assemble the documentation Aetna reviewers expect.

Session limits & retreatment

  • Initial course: Up to 30 treatment sessions (5 days/week × 6 weeks) plus 6 taper sessions over 3 weeks
  • Beyond 36: May be individually reviewed for medical necessity
  • Retreatment: Covered for relapse when:
    • You meet initiation criteria again, and
    • Prior course achieved ≥50% improvement on standardized scales, and
    • Improvement was maintained for ≥2 months after the last course
    Repeat TMS within 60 days of the prior course is not considered medically necessary.

Not covered / investigational in this policy

  • Maintenance TMS(outside the 30+6 course)
  • Accelerated/high-dose and theta-burst protocols (e.g., SAINT-type)
  • Adjunctive ketamine with TMS(combined use considered investigational)
  • Other diagnoses outside severe unipolar MDD without psychosis

We’ll align your plan with covered protocols and discuss any non-covered options transparently.

What TMS Is — and Why Aetna Members Choose It

Transcranial Magnetic Stimulation uses focused magnetic pulses to stimulate brain circuits involved in mood regulation. Sessions are noninvasive, require no anesthesia, and typically allow you to drive afterward. A standard Aetna-covered course runs 6 weeks of daily weekday sessions plus a short taper, with your symptoms tracked on validated scales throughout care.

Who benefits

  • Aetna members with severe MDD without psychosis
  • Those who tried two antidepressants and an augmentation strategy without adequate relief or with intolerance
  • Patients seeking a medication-sparing, evidence-based option delivered on an FDA-cleared device

How we personalize care

  • Baseline and follow-up rating scales every 2 weeks
  • Motor threshold determination and precise coil placement
  • Progress-informed adjustments within covered protocol parameters

Pre-Authorization & Cost with Aetna

Our coordinators verify your Aetna benefits, estimate out-of-pocket costs, and submit a complete pre-auth packet. We include the psychiatric diagnosis, medication and augmentation history (dose/duration or intolerance), baseline rating-scale scores, and the planned FDA-cleared protocol — exactly what reviewers look for.

  1. Benefits check: We confirm eligibility, copays, coinsurance, and deductibles
  2. Documentation: We compile notes and rating-scale data required by Aetna
  3. Authorization: We manage requests, peer-to-peer reviews, and appeals
  4. Scheduling: Once approved, we begin weekday sessions (about 20–25 minutes)

Frequently Asked Questions (Aetna)

Does Aetna cover TMS for conditions other than depression?

This policy’s covered indication is severe unipolar MDD without psychosis. Many other conditions (e.g., OCD, PTSD, chronic pain) are categorized as investigational or not medically necessary within this policy bulletin.

How many sessions are covered?

Aetna outlines up to 30 treatment sessions plus 6 taper sessions per course, with possible review beyond 36 for medical necessity.

Can I repeat TMS if I relapse?

Retreatment may be covered ≥2 months after a prior course if you meet initiation criteria, previously achieved ≥50% improvement, and relapsed despite appropriate care. Repeat within 60 days is not covered.

Are accelerated or theta-burst TMS options covered?

No. Accelerated/high-dose and theta-burst protocols (including SAINT-type) are considered experimental/investigational in this policy. Maintenance/booster TMS is also not covered.

Get Aetna-Covered TMS in Tampa or Wesley Chapel

We’ll confirm your Aetna eligibility, submit pre-authorization, and give you a clear out-of-pocket estimate before your first session.

📞 Call (813) 867-2378 📅 Request an Aetna coverage check

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Florida TMS Clinic — Tampa

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Wesley Chapel

Florida TMS Clinic — Wesley Chapel

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Aetna covers TMS for severe, non-psychotic Major Depressive Disorder when policy criteria are met. We’ll handle your pre-authorization.
📞 Call (813) 867-2378 📅 Check my Aetna coverage

Florida TMS Clinic

In-network TMS for Aetna in Tampa & Wesley Chapel. Evidence-based depression care with validated outcomes.

Phone: (813) 867-2378

Locations: Tampa · Wesley Chapel