- 21297 Foothill Blvd, Ste 203 Hayward, CA 94541 (by appointment only)
- (415) 636-9700
- hello@exxceedwellness.com
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.
Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC
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.
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.
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.
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.
The sequence is the same for most patients:
Our prior-authorization documentation checklist covers exactly what the packet must contain, and how long approval takes sets expectations on timing.
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.
Yes, for treatment-resistant major depressive disorder, with prior authorization and documented failed antidepressant trials or a failed psychotherapy trial.
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.
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.
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.
Coverage focuses on treatment-resistant depression. Other uses are handled case by case and may not be covered. Ask before you start.
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.
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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