Six state Medicaid programs — including New Jersey, Louisiana, Idaho, Alabama, West Virginia, and Mississippi — added or expanded coverage for transcranial magnetic stimulation in the first half of 2025, bringing total state Medicaid coverage to 38 states. Twelve states still do not provide Medicaid coverage for TMS, all in the southeast and mountain west regions.
State Medicaid coverage typically follows the structure of Medicare's national coverage decision, requiring documentation of failed antidepressant trials and a major depressive disorder diagnosis. Several state programs add additional state-specific criteria, such as documentation of psychotherapy attempts.
Expansion has been driven in part by advocacy from state psychiatric associations and from cost-effectiveness analyses showing TMS is cost-saving versus continued sequential pharmacotherapy. The patient population covered by Medicaid expansion is significant: roughly one in five Americans is enrolled in Medicaid.
Advocacy groups continue to push for federal Medicaid mandate consideration. The remaining 12 non-covering states have not signaled imminent policy changes.
Source
Reporting based on coverage from CMS. This article is editorial summary intended for general information; it is not medical advice.