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Does Aetna Cover TMS in California?

Does Aetna cover TMS?

Yes. Aetna covers TMS as medically necessary for treatment-resistant major depressive disorder, with prior authorization. Aetna’s clinical policy sets specific requirements for the antidepressant trials that must precede TMS.

Key facts

Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC

  • Aetna covers TMS as medically necessary for treatment-resistant major depressive disorder, with prior authorization.
  • Aetna requires an inadequate response to at least two antidepressants from two different classes before TMS.
  • Exxceed Wellness is in network with Aetna and handles the prior-authorization paperwork.
  • Documentation of past medication trials is the deciding factor in approval.
  • Where this is delivered: TMS at Exxceed Wellness is delivered in person at our Hayward, California clinic. A standard course is 36 sessions: 30 treatments five days a week over about six weeks, then a six-session taper over three weeks, after an initial evaluation and a mapping session. Some patients need fewer. Telehealth across California covers ADHD, psychiatric evaluation and medication management.

What Aetna requires

  • Diagnosis: major depressive disorder.
  • Prior treatment: inadequate response to at least two antidepressants from two different classes, each at a maximally tolerated labeled dose for at least eight weeks within the last five years, or failure of an adequate trial of evidence-based psychotherapy.
  • Documentation: treatment history and standardized depression scores, such as the PHQ-9.
  • Provider: an in-network provider trained on an FDA-cleared TMS system.

Prior authorization

Aetna requires prior authorization before treatment. Your provider submits the treatment history, depression scores, and a formal recommendation. Once approved, coverage generally holds for the acute course, about 30 sessions over roughly six weeks.

Your cost with Aetna

Once TMS is authorized and you see an in-network provider, you pay your usual specialist cost-sharing, often $0 to $60 per session after your deductible. For the full breakdown, see our TMS cost guide.

Who qualifies under Aetna’s criteria

Aetna publishes its requirements in Clinical Policy Bulletin 0469. The core of it is the medication history. Aetna asks for trials of two antidepressants from at least two different classes with different mechanisms of action, each taken at the maximally tolerated labeled dose for at least 8 weeks. An augmentation strategy can count instead: a primary antidepressant used at least 8 weeks alongside an augmenting agent, and if that augmenting agent is itself an antidepressant it must come from a different class.

Two details matter in practice. First, “at the maximally tolerated dose” means a low starter dose you never titrated may not count as a completed trial. Second, the order for treatment or re-treatment must be written by a psychiatrist or a psychiatric-mental health nurse practitioner who has examined you and reviewed the record. Nefretiri Abat is a PMHNP-BC, so that requirement is met in our clinic.

How many sessions Aetna covers

Aetna expects treatment to follow the protocol in the device manufacturer’s user manual, which for standard TMS means an acute course of about 36 sessions: five sessions per week for roughly six weeks, followed by a short taper. Sessions beyond a standard course, and any second course later, are reviewed separately on their own documentation. What decides those requests is measured change, which is why we track symptom scores throughout treatment rather than only at the start. Our guide to how many TMS sessions insurance approves explains the pattern across plans.

How to start TMS with Aetna

The sequence is the same for most patients:

  1. Call the member number on your card and confirm TMS (CPT 90867, 90868, 90869) is a covered benefit on your specific plan.
  2. Gather your medication history: drug names, doses reached, how many weeks you took each, and what happened. Pharmacy printouts are the fastest way to reconstruct this.
  3. Complete an evaluation with a qualified prescriber, including a baseline symptom score such as the PHQ-9 and screening for contraindications like ferromagnetic implants near the head or a seizure history.
  4. We assemble and submit the prior-authorization packet, then confirm the decision with you before any treatment is scheduled.

Our prior-authorization documentation checklist covers exactly what the packet must contain, and how long approval takes sets expectations on timing.

Does Exxceed Wellness accept Aetna?

Yes. We accept Aetna for TMS. We verify your benefits, assemble the required documentation, and handle the prior authorization. Contact us to check your Aetna coverage, or learn about our TMS program.

Frequently asked questions

Does Aetna cover TMS for depression?

Yes, for treatment-resistant major depressive disorder, with prior authorization and documented failed antidepressant trials or a failed psychotherapy trial.

How many failed medications does Aetna require?

At least two antidepressants from two different classes, each at an adequate dose for at least eight weeks within the last five years. A failed course of evidence-based psychotherapy can also qualify.

How many antidepressants does Aetna require before TMS?

Two antidepressants from at least two different classes with different mechanisms of action, each at the maximally tolerated labeled dose for at least 8 weeks. An augmentation strategy alongside a primary antidepressant used at least 8 weeks can also satisfy the requirement.

Can a nurse practitioner order TMS under Aetna?

Yes. Aetna’s policy states the order for treatment or re-treatment may be written by a psychiatrist or a psychiatric-mental health nurse practitioner who has examined the patient and reviewed the record.

Does Aetna cover TMS for OCD?

Coverage focuses on treatment-resistant depression. Other uses are handled case by case and may not be covered. Ask before you start.

References

  1. Aetna. Clinical Policy Bulletin 0469: Transcranial Magnetic Stimulation and Cranial Electrical Stimulation: aetna.com.
  2. California SB-855, mental health parity (effective January 1, 2021): official bill text.
  3. Perera T, et al. The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder. Brain Stimulation. 2016;9(3):336-346: PubMed.

Educational information only, not medical or financial advice. Coverage and criteria for TMS vary by plan and can change. TMS is FDA-cleared for major depressive disorder and, as an add-on, for OCD. Confirm your eligibility and benefits with a qualified clinician and Aetna.

Related coverage guides

We provide TMS in person at our Hayward, CA psychiatric clinic.


Care at Exxceed Wellness — Hayward, CA & California telehealth. We deliver FDA-cleared TMS on the Magstim Horizon 3.0 — for treatment-resistant depression, adult OCD, and adolescents 15–21 (depression, as an add-on to medication). Learn more ›, schedule a consultation, or call (415) 636-9700.

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