Starting a
TMS Clinic
From equipment selection and staffing to insurance credentialing and patient acquisition. Everything you need to launch a successful TMS practice.
Requirements by Practice Type
Solo Psychiatrist
- Full control over operations
- Higher per-patient revenue
- Flexible scheduling
- Higher personal financial risk
- Coverage challenges during time off
- Administrative burden
Group Practice
- Shared costs and risk
- Built-in referral network
- Coverage redundancy
- Profit sharing
- Decision-making complexity
- Space requirements
Hospital / Health System
- Institutional support
- Established patient pipeline
- Credentialing infrastructure
- Bureaucratic approval process
- Lower physician autonomy
- Revenue sharing with system
Equipment Options ($70K-$150K)
NeuroStar TMS Therapy System
Neuronetics · Figure-8 coil
BrainsWay Deep TMS
BrainsWay · H-coil (deep TMS)
MagVenture MagPro
MagVenture · Various coil options
CloudTMS
CloudTMS / Apollo TMS · Figure-8 coil with neuronavigation
Staffing Needs
Supervising Psychiatrist
RequiredMust be on-site or available for real-time consultation. Prescribes TMS, reviews treatment plans, and handles adverse events.
TMS Technician
RequiredOperates the device, monitors patients during sessions, documents treatment parameters. Certification through manufacturer training.
Billing Specialist
Highly RecommendedHandles prior authorizations, claims submission, denial management. TMS billing is complex — specialized experience saves revenue.
Front Desk / Patient Coordinator
RecommendedSchedules 36+ session treatment courses, manages patient communications, handles intake paperwork.
Marketing Coordinator
OptionalManages online presence, physician outreach, and patient education. Critical for patient acquisition in the first 12 months.
Launch Timeline (6 Months)
Planning & Business Case
Month 1-2- Develop business plan and financial projections
- Evaluate device options and negotiate pricing
- Identify space requirements (200-400 sq ft dedicated)
- Consult healthcare attorney on regulatory requirements
Equipment & Setup
Month 2-4- Purchase or lease TMS device
- Renovate treatment space (shielding usually not required)
- Install equipment and complete manufacturer training
- Set up EMR integration and treatment documentation
Insurance Credentialing
Month 3-6- Apply for TMS-specific credentialing with payers
- Obtain prior authorization protocols for each insurer
- Set up billing codes and fee schedules
- Contract with Medicare and major commercial payers
Staff Hiring & Training
Month 3-5- Hire TMS technician and billing specialist
- Complete manufacturer device certification
- Develop clinical protocols and safety procedures
- Train staff on patient screening and monitoring
Marketing & Launch
Month 5-6- Build referral relationships with local psychiatrists and PCPs
- Launch website and online directory listings
- Begin accepting patient referrals
- Run initial patient information seminars
ROI Projections
Key takeaway: Most TMS clinics break even at 4-6 patients per day. With a standard treatment course of 36 sessions, each new patient represents $5,400-$9,000 in revenue. Practices treating 6-8 patients daily can expect $500K-$800K in annual TMS revenue once fully ramped.
Regulatory Requirements
FDA Requirements
- Use only FDA-cleared TMS devices
- Treat only FDA-cleared indications (or document off-label use)
- Follow manufacturer protocols for treatment delivery
- Maintain device maintenance and calibration records
State Medical Board
- Supervising physician must hold active state medical license
- Check state-specific supervision requirements for technicians
- Comply with informed consent documentation requirements
- Maintain malpractice insurance covering TMS procedures
Ready to Launch?
List Your New Clinic on TMS List
Once your clinic is operational, add it to our directory to start receiving patient enquiries from day one.
Also: insurance credentialing guide or TMS Buyer's Guide for patients.