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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.