- 21297 Foothill Blvd, Ste 203 Hayward, CA 94541 (by appointment only)
- (415) 636-9700
- hello@exxceedwellness.com
Yes. Cigna covers TMS as medically necessary for major depressive disorder, for patients aged 15 and older who have not responded adequately to antidepressants. As of March 6, 2026, Cigna and Evernorth no longer require prior authorization for in-network providers, though the medical-necessity criteria still apply.
Updated August 2026 · Reviewed by Nefretiri Abat, PMHNP-BC
Effective March 6, 2026, contracted in-network providers no longer need prior authorization before delivering TMS to Cigna and Evernorth members. Out-of-network providers still require prior authorization. Removing prior authorization does not remove the criteria. The provider must document that you meet Cigna’s medical-necessity standard, or the claim can be denied after treatment.
When 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.
Cigna and Evernorth set their requirements in coverage policy 0383. The prior-authorization step changed in 2026, but the medical-necessity framework did not: the policy still defines who qualifies, when a repeat course is covered, and which uses stay non-covered. In practice that means a major depressive disorder diagnosis, a documented history of adequate antidepressant trials that did not work, and screening for contraindications.
This distinction is the one patients most often get wrong. No prior authorization does not mean automatic payment. Claims are still measured against policy 0383 after the fact, so the chart still has to show the same things it always did.
A standard acute course runs about 36 sessions, five per week for roughly six weeks plus a taper. Repeat courses are addressed separately in the policy and turn on whether you responded to the earlier course and whether symptoms have measurably returned. Because policy 0383 governs repeat courses specifically, we document symptom scores across treatment rather than only at intake. See how many TMS sessions insurance approves for the broader pattern.
Our documentation checklist lists what the record needs either way.
Yes. We accept Cigna for TMS. As an in-network provider, we confirm you meet the medical-necessity criteria and document your history before treatment. Contact us to check your Cigna coverage, or learn about our TMS program.
As of March 6, 2026, in-network providers do not. Out-of-network providers still do. Either way, the medical-necessity criteria must be met and documented.
Yes, for major depressive disorder in patients 15 and older who have not responded adequately to antidepressants.
Effective March 6, 2026, Cigna removed the prior-authorization requirement for TMS for Evernorth-contracted in-network providers. Out-of-network care is still reviewed separately, and some plans may still require it depending on the Summary Plan Description.
No. Coverage policy 0383 still sets the medical-necessity criteria. Removing the prior-auth step streamlines the paperwork; it does not remove the requirement to meet and document the clinical criteria.
Cigna’s policy includes TMS for OCD. Confirm the specific criteria for your plan before starting.
Educational information only, not medical or financial advice. Coverage rules and prior-authorization requirements 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 Cigna.
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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