Key takeaways
- Cigna’s TMS policy includes depression coverage for qualifying adults and adolescents.
- Evidence-based psychotherapy and medication history are part of the eligibility review.
- A separate adult OCD coverage pathway is available under specific criteria.
- The authorization change does not replace a benefits check or clinical assessment.
Cigna and Evernorth: what changed about authorization?
Effective March 6, 2026, Evernorth removed TMS prior authorization for contracted providers treating patients covered under applicable Evernorth/Cigna plans.
Out-of-network care and network exceptions generally still require authorization, with account-specific exceptions. Cigna Connect members receiving care outside their insured state may also face different network rules.
We check your benefits, our participation in your product, and any remaining approval requirements before scheduling treatment.
Cigna TMS coverage at a glance
The table summarizes commercial policy EN0383. Medicare Advantage and other benefit arrangements require the appropriate coverage review.
| Coverage question | Published policy summary |
|---|---|
| Depression diagnosis | Moderate-to-severe unipolar MDD without psychosis |
| Age | 15 or older |
| Adults’ medication history | Two antidepressant trials from two classes during the current episode |
| Ages 15–17 | Two antidepressant trials |
| Adequate medication trial | At least four weeks at therapeutic doses; intolerance/contraindication alternatives |
| Psychotherapy | An adequate evidence-based trial without significant improvement |
| Augmentation | Not a separate universal requirement |
| Symptom ratings | Validated scale at the beginning and end of each course |
| Initial course | 30–36 treatments |
| Repeat depression course | Prior improvement greater than 50%, maintained for at least two months, followed by recurrence/relapse |
| Maintenance | Not medically necessary under this policy |
| Accelerated treatment | Classified as investigational/unproven; clarify daily iTBS protocol coverage |
Coverage question
Depression diagnosis
Moderate-to-severe unipolar MDD without psychosis
Age
15 or older
Adults’ medication history
Two antidepressant trials from two classes during the current episode
Ages 15–17
Two antidepressant trials
Adequate medication trial
At least four weeks at therapeutic doses; intolerance/contraindication alternatives
Psychotherapy
An adequate evidence-based trial without significant improvement
Augmentation
Not a separate universal requirement
Symptom ratings
Validated scale at the beginning and end of each course
Initial course
30–36 treatments
Repeat depression course
Prior improvement greater than 50%, maintained for at least two months, followed by recurrence/relapse
Maintenance
Not medically necessary under this policy
Accelerated treatment
Classified as investigational/unproven; clarify daily iTBS protocol coverage
Your actual benefits, clinical circumstances, and proposed device/protocol also matter.
Does Cigna cover TMS for OCD?
The policy provides a separate adult deep-TMS pathway:
| OCD coverage question | Published policy summary |
|---|---|
| Age | 18+ |
| Previous treatment | Two unsuccessful medication trials, generally eight weeks each, or intolerance/contraindication |
| Psychotherapy | Unsuccessful adequate evidence-based trial |
| Monitoring | Y-BOCS before and after each course |
| Repeat course | Greater than 30% prior improvement, maintained at least two months, followed by relapse |
OCD coverage question
Age
18+
Previous treatment
Two unsuccessful medication trials, generally eight weeks each, or intolerance/contraindication
Psychotherapy
Unsuccessful adequate evidence-based trial
Monitoring
Y-BOCS before and after each course
Repeat course
Greater than 30% prior improvement, maintained at least two months, followed by relapse
An OCD request needs its own clinical review and an appropriate device/protocol. Depression authorization or benefits should not be assumed to establish OCD coverage.
What should I bring to a coverage review?
Helpful information includes:
- Your complete insurance card and plan information.
- Medication names, doses, treatment dates, and outcomes.
- Records describing side effects or medication contraindications.
- Psychotherapy type, frequency, duration, and response.
- Details of previous TMS courses, if applicable.
Tell us where you received prior care. We can explain which records are needed and help coordinate documentation.
What will TMS cost with Cigna?
Your estimated responsibility depends on your deductible, copayments or coinsurance, network status, and benefits.
We check those details before treatment. If your plan has no TMS prior authorization requirement, you may still have a patient cost share. We explain the expected course and provide an individualized estimate.
How we help Cigna members get started
- 1Identify your specific Cigna/Evernorth product and applicable benefits.
- 2Review your history and arrange the clinical evaluation.
- 3Confirm the authorization requirements for your provider and plan.
- 4Explain costs, records needed, and scheduling options.
When an authorization or exception request is required, our team prepares the supporting information and follows the applicable process.
Frequently asked questions
Yes. Treatment still needs a clinical assessment and appropriate documentation. Your benefits, diagnosis, previous care, and proposed protocol remain relevant.
A recommendation is an important clinical step. Coverage also depends on the benefit terms and applicable policy requirements.
Let us know who is involved in your care. We can coordinate records and communication, with your consent, as part of the treatment plan.
Tell us which protocol you are considering. We review the actual device and schedule against your plan’s coverage and obtain clarification when needed before representing it as covered.
Contact us for an assessment. We review your previous outcomes, duration of benefit, current symptoms, and available coverage.
Check your Cigna TMS benefits
Florida TMS Clinic provides TMS care in Wesley Chapel and Tampa. Our team can help you understand your options and the steps needed to begin.
Call (813) 867-2378 or request your coverage check.
Compare coverage with other insurers.
Policy information checked November 1, 2026. Coverage depends on your benefits, clinical eligibility, network status, and required approvals. Verification and authorization do not guarantee payment.
Official policy references
Medical information on this page is educational and not a substitute for professional advice. Individual results vary.