Insurance & Payer Reference

CPT codes, payer coverage criteria, and prior auth templates.

CPT Codes for TMS

CPT	Description	Rate	Payer Coverage	Notes
90867	Therapeutic repetitive TMS, initial delivery	$350–$650	Medicare + Most insurers	Used for the first session including motor threshold mapping. Billable once per treatment course.
90868	Therapeutic repetitive TMS, subsequent delivery	$200–$450	Medicare + Most insurers	All sessions after the initial mapping. The majority of billing is under this code.
90869	Motor threshold determination for TMS	$75–$150	Variable	May be billed separately or bundled. Some payers require separate documentation of MT procedure.

Insurance Payer Coverage Details

Disclaimer: Coverage information is based on publicly available payer policies and is subject to change. Always verify current coverage requirements directly with the payer. TMSList is not responsible for coverage decisions. This tool is for educational purposes only.

Keep exploring