CMS authorized Medicare reimbursement for transcranial magnetic stimulation delivered under telehealth physician supervision in designated rural and medically underserved areas. The change addresses a significant access gap: roughly 28% of U.S. counties have no TMS clinic within 50 miles, and many of those are in areas that already lack psychiatric coverage.
Under the new rule, a credentialed TMS technician may deliver sessions in person while a supervising psychiatrist provides oversight remotely. Initial motor threshold determination and treatment planning must still occur in person, but maintenance sessions may proceed under remote supervision.
The Clinical TMS Society welcomed the change while noting state-level supervision laws will determine practical impact. Roughly 30 states currently align with the federal allowance; the remainder require in-person physician presence for any TMS session.
Commercial payer coverage for telehealth-supervised TMS is mixed. Several large national payers indicated they would align with Medicare; others have not yet released policies. The change is expected to support expanded TMS clinic deployment in rural areas over the next two to three years.
Source
Reporting based on coverage from CMS. This article is editorial summary intended for general information; it is not medical advice.