Coverage
What TMS costs in Oregon and how insurers approve it
Nearly every major Oregon plan covers TMS for depression. The hold-up is almost never coverage — it is documentation.
Oregon's major insurers cover TMS for major depressive disorder when earlier treatment has not worked. Plans typically require documented trials of antidepressants and psychotherapy, plus prior authorization. Oregon Health Plan (Medicaid) coverage runs through coordinated care organizations (CCOs), so criteria vary by CCO. Medicare covers TMS for depression under its regional coverage rules. Always confirm benefits with the clinic before starting treatment.
Plan by plan
Regence BlueCross BlueShield of Oregon
Covers TMS for treatment-resistant depression with prior authorization.
Providence Health Plan
Covers TMS under the behavioral health benefit with prior authorization.
Kaiser Permanente Northwest
Coverage and referral handled within the Kaiser network.
Moda Health
Covers TMS for depression when medication trials are documented.
PacificSource
Covers TMS with prior authorization on many commercial plans.
Aetna
Covers TMS with medication-trial documentation.
Oregon Health Plan (CCOs)
Medicaid coverage runs through coordinated care organizations; criteria vary by CCO.
Medicare
Covers TMS for major depressive disorder under regional coverage rules.
Criteria change. Treat this as a starting point and confirm with your plan and clinic.
Self-pay price ranges
- Single session, self-pay
- $200 – $400
- Full 36-session course, self-pay
- $8,000 – $13,000
- Typical insured out-of-pocket
- Deductible + per-visit copay
- Initial mapping / brain mapping visit
- $300 – $500
Many Oregon clinics offer payment plans or a discounted bundled rate for a full course — ask when you call.
Getting approved faster
- Bring a list of every antidepressant you have tried, with doses and how long you took them.
- Ask your prescriber to note the reason each medication was stopped — side effects count.
- Have a recent PHQ-9 or similar score on file; most insurers want a current measure.
- Let the clinic submit the authorization — their staff do this daily and know the templates.
- If you are denied, appeal. Denials for incomplete documentation are routinely overturned.
Looking for a clinic that takes your plan? Filter the directory by insurance.