- 21297 Foothill Blvd, Ste 203 Hayward, CA 94541 (by appointment only)
- (415) 636-9700
- hello@exxceedwellness.com
Key facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC TMS prior authorization is decided on the chart: diagnosis, measured symptom severity, and a complete antidepressant trial history. Each medication trial must be documented
Read MoreKey facts Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC A standard insurance-authorized TMS course is 36 sessions: 5 per week for about 6 weeks, then a 6-session taper. Insurers authorize the course as
Read MoreDepression can return after a successful course of TMS, and most insurance plans anticipate that. Coverage for a second acute course, usually called re-treatment, is common when you responded the first time, symptoms have returned,
Read MoreTMS is FDA-cleared as an adjunct treatment for obsessive-compulsive disorder, so coverage for OCD is legitimate rather than experimental. It is, however, narrower and less uniformly covered than TMS for major depression. Plans generally require
Read MoreIf the clinic you want is not in network with your plan, you are not automatically out of options. Many PPO plans reimburse a share of out-of-network care after a separate deductible, and a superbill
Read MoreWith a complete submission, most California plans decide a standard prior authorization request for TMS or Spravato within a few days to about two weeks. California law also provides for expedited review when waiting would
Read MoreBefore you start TMS or Spravato, three things decide whether treatment is covered: whether the benefit exists on your plan, whether you meet the medical necessity criteria, and whether the authorization is submitted with complete
Read MoreAnthem Blue Cross plans in California generally cover TMS therapy for major depressive disorder when medical necessity criteria are met, and prior authorization is nearly always required. The deciding factor is documentation: your plan wants
Read MoreIf your California health plan denied TMS therapy, you have a formal appeal path with real teeth, and denials are overturned regularly. The sequence is: understand the stated reason, file an internal appeal (called a
Read MoreDepression alongside a chronic illness like diabetes, heart disease, or an autoimmune condition is common, worsens the course of both conditions, and is frequently left untreated because everyone is focused on the physical disease. If
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