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

Humana Coverage for TMS Therapy

Florida TMS Clinic verifies Humana benefits, manages pre-authorization, and delivers FDA-cleared TMS for depression — with measurement-based care and flexible scheduling.

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

In-network, outcomes-focused

TMS that fits your Humana plan — and your life

We’re an experienced TMS center serving Tampa and Wesley Chapel with a comprehensive program: psychiatric evaluation, measurement-based care (PHQ-9, HAM-D, MADRS, BDI), FDA-cleared protocols, and collaborative follow-up with your therapist or PCP. Our coordinators submit the complete authorization packet and keep you informed at each step.

  • In-network for Humana plans(benefits vary by product and state)
  • Measurement-based care with validated scales every two weeks
  • Clear expectations on trials, ECT requirement, retreatment, and documentation
  • Flexible scheduling and quick pre-auth turnaround

Humana TMS Coverage: Eligibility & What’s Included

Eligibility checklist (MDD)

  • Age: 18 or older
  • Diagnosis: Major depressive disorder (current episode)
  • Medication trials:
    • Failure of four antidepressant agents from at least two classes, and
    • At least two of those trials at standard therapeutic doses for ≥6 weeks each
    or intolerance/contraindication to antidepressants (e.g., drug interactions or distinct side effects on four agents)
  • ECT status: attempted, medically contraindicated, or offered and declined
  • Contraindications: none present (see safety list below)
  • Referral: psychiatrist referral prior to treatment

Retreatment rules

  • Current depressive symptoms have worsened by ≥50% from the prior best PHQ-9 score, and
  • Prior course produced a ≥50% reduction from baseline on standardized scales, and
  • No new contraindications to TMS

We document baseline and follow-up scores to meet these requirements.

Safety & contraindications

  • Active suicidality
  • History/risk of seizures during TMS
  • Pacemakers/ICDs and other implants controlled by physiologic signals
  • Conductive/ferromagnetic metals within ~30 cm of the coil (e.g., aneurysm clips, cochlear/ocular implants, DBS, certain stents)
  • Active or inactive implants (including device leads) near the head/neck
  • Active psychosis or catatonia where rapid response is needed
  • Additional exclusions sometimes cited: active substance abuse, severe dementia, severe cardiovascular disease

We perform a comprehensive safety screen before starting treatment.

Benefits and prior-authorization steps can vary across Humana product lines and states. We verify your member-specific coverage and advise you on any plan nuances.

What TMS Is — and Why Humana Members Choose It

Transcranial Magnetic Stimulation uses focused magnetic pulses to stimulate mood circuits in the brain. Sessions are noninvasive, require no anesthesia, and you can typically drive afterward. A standard course runs weekday sessions for several weeks, with validated rating scales tracked throughout.

Who benefits

  • Humana members whose depression has not improved on multiple antidepressants
  • Those with medication intolerance or contraindications
  • Patients seeking a medication-sparing, psychiatrist-supervised treatment

How we personalize care

  • Baseline and every-2-weeks rating scales (e.g., PHQ-9, HAM-D, MADRS, BDI)
  • Motor threshold mapping and precise coil placement
  • Progress-informed adjustments within covered protocol parameters

Pre-Authorization & Cost with Humana

Our team verifies your benefits, estimates out-of-pocket costs, and submits a complete pre-auth packet. We include psychiatric documentation, detailed medication/augmentation history (dose, duration, intolerance), baseline scales, and an FDA-cleared protocol — exactly what reviewers look for.

  1. Benefits check: Eligibility, copays, coinsurance, deductibles
  2. Documentation: Clinician notes and rating-scale data that match Humana’s criteria
  3. Authorization: We manage requests, peer-to-peers, and appeals when needed
  4. Scheduling: Once approved, we begin weekday sessions (about 20–25 minutes)

Frequently Asked Questions (Humana)

Does Humana require four medication trials?

Yes. Coverage typically requires failure of four antidepressant agents from at least two different classes, with at least two trials at standard dosing for six weeks or longer — or documented intolerance/contraindication.

Is ECT required before TMS?

Humana expects ECT to have been attempted, be medically contraindicated, or have been offered and declined by the member.

Is maintenance TMS covered?

No. Maintenance/booster TMS is not considered medically necessary.

What are the retreatment criteria?

Retreatment may be covered when symptoms have worsened by at least 50% from the prior best PHQ-9 score, the prior course achieved at least 50% improvement, and no new contraindications are present.

Get Humana-Covered TMS in Tampa or Wesley Chapel

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

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

Tampa

Florida TMS Clinic — Tampa

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Wesley Chapel

Florida TMS Clinic — Wesley Chapel

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Humana covers TMS for major depressive disorder when plan criteria are met. We’ll handle your pre-authorization.
📞 Call (813) 867-2378 📅 Check my Humana coverage

Florida TMS Clinic

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

Phone: (813) 867-2378

Locations: Tampa · Wesley Chapel