The American Medical Association added two new Current Procedural Terminology (CPT) codes effective January 2026 that distinguish theta burst transcranial magnetic stimulation from standard 10Hz repetitive TMS. The previous codes (90867-90869) bundled all TMS protocols regardless of stimulation pattern.
The new codes are intended to support more accurate clinical tracking and to allow payers to set protocol-specific reimbursement if they choose. Many clinics deliver theta burst preferentially because of throughput advantages — sessions are typically 9-10 minutes versus 37 for standard 10Hz — but reimbursement until now has been identical regardless of session length.
Industry response is mixed. Some clinics worry that theta burst-specific codes will be reimbursed at lower rates given shorter session times. The Clinical TMS Society indicated it will advocate for outcome-equivalent reimbursement, citing the 2025 meta-analysis showing equivalent efficacy.
CMS is expected to issue guidance on Medicare reimbursement under the new codes by late 2025. Commercial payer policies typically follow Medicare with a 6-12 month lag.
Source
Reporting based on coverage from American Medical Association. This article is editorial summary intended for general information; it is not medical advice.