Refer a Patient: TMS and Spravato in Hayward, CA

If your patient has not responded to two or more antidepressants, we can take the referral. We provide TMS and Spravato at our Hayward clinic and send your patient back to you for the therapy work. You keep the therapeutic relationship. We contact every referred patient within three business days.

Who to refer

• Adults with major depressive disorder that has not responded to two or more antidepressant trials at a full dose
• Patients who cannot tolerate antidepressants, or who lost response over time
• Adults with OCD that has not responded adequately to SSRIs and ERP (TMS is FDA-cleared as an adjunct)
• Adolescents 15 to 21 with major depressive disorder (TMS is FDA-cleared as an add-on in this age range)
• Patients with active suicidal ideation alongside major depressive disorder, where Spravato carries a specific FDA approval

If you are unsure whether someone qualifies, send them anyway. We will tell you honestly if they are not a candidate.

Does your patient stay with you?

Yes, and this is the part most referring clinicians want answered first.

We treat the interventional piece. Your patient continues therapy with you throughout. TMS and Spravato both work best alongside ongoing psychotherapy, and neither one replaces it. We are not looking to absorb your caseload.

If you would like progress updates, tell us and we will send them with your patient’s written authorisation.

What to send with the referral

The single most useful thing is an accurate medication history. Insurance approval depends on it, and it is what slows referrals down most often.

• Every antidepressant tried, the highest dose reached, and how long the patient stayed on it
• Why each one stopped, meaning non-response, side effects, or something else
• Current medications, including any oral antidepressant they are staying on
• Relevant history: seizure history, implanted metal or devices in or near the head for TMS, aneurysm or vascular history for Spravato
• Insurance details

What happens next

1. We contact your patient directly to schedule an evaluation, within three business days.
2. We assess candidacy and confirm which treatment fits, if either does.
3. We verify benefits and submit prior authorisation. Your office does not handle that paperwork.
4. We give the patient their expected out-of-pocket cost before the first session.
5. Treatment begins, and your patient continues therapy with you.

Coverage

We are in network with Aetna, Anthem Blue Cross Blue Shield, Blue Shield of California, Cigna, UnitedHealthcare, Medi-Cal, and Medicare. Both treatments generally require prior authorisation, which we handle. See fees and insurance.

What we offer

• TMS therapy on a Magstim Horizon 3.0. Standard 10Hz rTMS and three-minute theta-burst protocols. Focal stimulation, not deep TMS.
• Spravato (esketamine) in office under REMS, with post-dose monitoring.
• Psychiatric evaluation and medication management, in person and by telehealth across California.

Evidence base: adding esketamine to a newly started antidepressant outperformed the antidepressant alone in the registration trial (Popova 2019), and continuation roughly halved relapse risk (Daly 2019). In 307 patients across 42 community clinics, TMS produced response in 58 percent and remission in 37 percent (Carpenter 2012).

How to refer

Use the form below, or call (415) 636-9700. We contact your patient within three business days.

Referrals are accepted from psychotherapists, primary care, psychiatric providers, and case managers. A formal referral is not required for a patient to book with us directly.

Referral request

Please do not enter patient names, dates of birth, or clinical details in this form. It is a standard web form and is not a secure channel for protected health information. Send us your details here and we will call you to take the clinical handoff securely.

Include your name, practice, and the best number and time to reach you. A one-line note such as “adult, two failed antidepressant trials, asking about TMS” is enough for us to route it correctly.

If you would rather speak first, call (415) 636-9700 and say you are a referring clinician.

Common questions from referring clinicians

Will you take over my patient’s care?

No. We handle the interventional treatment. Your patient continues therapy with you.

Do you accept referrals for patients who are not sure about TMS or Spravato?

Yes. An evaluation is a conversation about options. Some patients leave having decided to adjust medication instead.

What if my patient does not qualify?

We tell you and the patient plainly, and outline what else might help.

How long does insurance approval take?

Usually one to two weeks once documentation is submitted. A complete medication history speeds this up more than anything else.

Can you see patients by telehealth?

Evaluation and medication management, yes, anywhere in California. TMS and Spravato are in-person treatments at the Hayward clinic.

References

• Popova V, Daly EJ, Trivedi M, et al. Efficacy and safety of flexibly dosed esketamine nasal spray in treatment-resistant depression. Am J Psychiatry. 2019;176(6):428-438. PubMed
• Daly EJ, Trivedi MH, Janik A, et al. Efficacy of esketamine nasal spray for relapse prevention in treatment-resistant depression. JAMA Psychiatry. 2019;76(9):893-903. PubMed
• Carpenter LL, Janicak PG, Aaronson ST, et al. Transcranial magnetic stimulation for major depression: a multisite naturalistic observational study. Depress Anxiety. 2012;29(7):587-596. Journal

Information for healthcare professionals. Candidacy for any treatment is determined by clinical evaluation. Coverage varies by plan. Results vary and no outcome is guaranteed.

Clinical contact: Nefretiri Abat, J.D., PMHNP-BC, board-certified Psychiatric-Mental Health Nurse Practitioner.