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

Cigna Coverage for TMS Therapy

Florida TMS Clinic is an in-network provider for Cigna/Evernorth. We verify your benefits, manage pre-authorization, and deliver FDA-cleared TMS for depression — with accessible scheduling and outcome-based care for adults and eligible adolescents.

📞 Call (813) 867-2378 📅 Request a Cigna coverage check Pre-authorization handled for you (Evernorth)

In-network, outcomes-focused

TMS that fits your Cigna plan — and your life

We’re an experienced TMS center serving Tampa and Wesley Chapel with a comprehensive 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 Evernorth, tracks your progress with validated scales, and keeps you and your care team informed.

  • In-network for Cigna/Evernorth Behavioral Health
  • Measurement-based care(PHQ-9, HAM-D, MADRS, BDI) to document improvement
  • Clear expectations on session count, adolescents vs adults, retreatment, and documentation
  • Flexible scheduling and quick turnarounds on pre-auth

Cigna TMS Coverage: Eligibility & What’s Included

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

Eligibility checklist (MDD)

  • Age: ≥15 years(adolescents 15–17 considered under specific rules)
  • Diagnosis: Unipolar major depressive disorder, moderate-to-severe, single or recurrent episode, without psychosis
  • Psychotherapy trial: An adequate, evidence-based psychotherapy course with no significant improvement
  • Validated scales: Administered at the beginning and end of the course (e.g., PHQ-9, HAM-D, MADRS, BDI)
  • Medication history:
    • Adults ≥18: Failure of ≥2 antidepressant trials from two classes(adequate dose/duration), or documented intolerance/contraindication
    • Adolescents 15–17: Failure of two antidepressant trials (adequate dose/duration) or documented intolerance

Session limits & retreatment

  • Initial course: 30–36 treatments (outpatient, FDA-cleared device)
  • Retreatment: Another 30–36 treatments may be covered for relapse when:
    • Prior course achieved >50% improvement on a standardized depression scale, and
    • Improvement was maintained for ≥2 months after the last course.

Maintenance/booster TMS is not considered medically necessary in this policy.

OCD coverage (dTMS)

Cigna may also cover deep TMS (dTMS) for adult OCD when all of the following are met: age ≥18, DSM-defined OCD, failure of ≥2 OCD medication trials (adequate dose/duration or intolerance), an adequate psychotherapy trial, and Y-BOCS scoring before/after the course. Repeat dTMS for OCD may be considered after relapse if the prior course produced >30% Y-BOCS improvement and the benefit was maintained for ≥2 months.

Not covered / investigational

  • Maintenance TMS: Not medically necessary under this policy
  • Other indications outside MDD and adult OCD are not covered (examples listed in policy)
  • Experimental/Investigational: Accelerated protocols, Theta Burst Stimulation (TBS), SAINT/SNT

Coverage always depends on your member-specific benefit plan and any applicable mandates. We verify your benefits and confirm documentation required by Evernorth.

What TMS Is — and Why Cigna Members Choose It

Transcranial Magnetic Stimulation(TMS) uses focused magnetic pulses to stimulate mood circuits in the brain. Sessions are noninvasive, require no anesthesia, and typically allow you to drive afterward. A standard course runs 4–6 weeks (one session per weekday), with validated rating scales tracked throughout.

Who benefits

  • Cigna members whose depression has not improved with antidepressants
  • Those who experienced side effects that made medications intolerable
  • Adults and eligible adolescents (15–17) who meet the policy criteria

How we personalize care

  • Baseline and follow-up rating scales every 2 weeks
  • Motor threshold determination and precise coil placement
  • Progress-based adjustments that remain within covered protocols

Pre-Authorization & Cost with Cigna

Our coordinators verify your Cigna benefits, estimate out-of-pocket costs, and submit a complete pre-auth packet to Evernorth. We include diagnostic documentation, psychotherapy history, antidepressant trial details (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 Evernorth
  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 (Cigna)

Does Cigna cover TMS for conditions other than depression?

This policy’s covered indications are MDD (adults and eligible adolescents) and, under specific criteria, adult OCD with deep TMS. Other conditions are listed as not medically necessary or investigational here.

How many sessions are covered?

Cigna/Evernorth describes an initial regimen of 30–36 treatments. Repeat courses may be covered after relapse if the prior course produced >50% improvement and the benefit lasted ≥2 months.

Is TMS covered for teens?

Yes, adolescents aged 15–17 may qualify for MDD under specific criteria (two antidepressant trials or documented intolerance, psychotherapy, validated scales). We’ll confirm eligibility during benefits verification.

Are accelerated or theta-burst TMS options covered?

No. This policy lists accelerated schedules, Theta Burst Stimulation (TBS), and SAINT/SNT as investigational at this time. We’ll align your plan to covered protocols and discuss any non-covered options transparently.

Get Cigna-Covered TMS in Tampa or Wesley Chapel

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

📞 Call (813) 867-2378 📅 Request a Cigna coverage check

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Florida TMS Clinic — Tampa

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Florida TMS Clinic — Wesley Chapel

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Cigna/Evernorth covers TMS for Major Depressive Disorder (and adult OCD with dTMS) when policy criteria are met. We’ll handle your pre-authorization.
📞 Call (813) 867-2378 📅 Check my Cigna coverage

Florida TMS Clinic

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

Phone: (813) 867-2378

Locations: Tampa · Wesley Chapel