The documents worth gathering before you apply for TMS coverage

Most TMS insurance denials we hear about are not refusals on the merits — they are submissions missing a piece of paperwork. If you are about to start the prior-authorization process, assembling these first will save you weeks. **1. A written medication history.** For every antidepressant: the drug, roughly the dose, roughly how long you took it, and why it ended. "Stopped at week 3 because of nausea" counts as a failed trial in most policies — intolerance is not the same as not trying. **2. Documentation of psychotherapy.** Most commercial policies want evidence you have participated in, or been offered, therapy. A note from your therapist or a line in your psychiatrist's record is usually enough. **3. A current symptom score.** A PHQ-9 takes three minutes and gives the reviewer a number to point at. Many policies specify a threshold. **4. Your policy's actual TMS criteria.** Search your insurer's name plus "transcranial magnetic stimulation medical policy" — most publish the exact checklist their reviewer uses. Reading it tells you which box you are short on before you get denied for it. Related reading: [the 2026 insurance coverage guide](/blog/tms-insurance-coverage-2026/), and if you have already been denied, [the appeals playbook](/blog/tms-insurance-appeals-complete-guide/) — a substantial share of TMS denials are overturned on appeal. If your plan handled this differently than described, reply and say so. Payer behaviour varies by state and by year, and first-hand reports are more current than any guide.