Cigna issued a revised behavioral health clinical policy bulletin removing the requirement that OCD patients first complete and fail two SSRI trials before authorizing deep transcranial magnetic stimulation. The policy now treats deep TMS as a first-line option for OCD that has not adequately responded to a single SSRI.
The change aligns Cigna with treatment guidance from the International OCD Foundation and recent comparative effectiveness analyses showing that response rates to deep TMS in OCD do not significantly differ between patients with one prior SSRI failure versus two or more.
BrainsWay's H7 deep TMS coil is currently the only FDA-cleared device for OCD. Treatment courses run 29 sessions over six weeks. Out-of-pocket costs without coverage typically exceed $14,000.
Advocacy groups welcomed the change. The OCD Foundation noted that the previous step-therapy requirement created an average 14-month delay between clinical eligibility and authorized treatment, during which symptoms often worsened.
Source
Reporting based on coverage from Cigna Behavioral Health. This article is editorial summary intended for general information; it is not medical advice.