Coverage
What TMS costs in Utah and how insurers approve it
Nearly every major Utah plan covers TMS for depression. The hold-up is almost never coverage — it is documentation.
Utah's major insurers cover TMS for major depressive disorder when earlier treatment has not worked. Plans typically require documented trials of antidepressants and psychotherapy, plus prior authorization. Utah Medicaid coverage runs through accountable care organizations and behavioral health plans, so criteria vary. Medicare covers TMS for depression under its regional coverage rules. Always confirm benefits with the clinic before starting treatment.
Plan by plan
SelectHealth
Covers TMS for treatment-resistant depression with prior authorization.
Regence BlueCross BlueShield of Utah
Covers TMS with documented medication trials and prior authorization.
University of Utah Health Plans
Covers TMS under the behavioral health benefit with authorization.
PEHP Health & Benefits
Utah public employee plan; confirm TMS criteria with the plan.
Cigna
Covers TMS with prior authorization and re-authorization during the course.
Aetna
Covers TMS with medication-trial documentation.
Utah Medicaid
Coverage varies by plan; confirm with both the plan and the clinic.
Medicare
Covers TMS for major depressive disorder under regional coverage rules.
Criteria change. Treat this as a starting point and confirm with your plan and clinic.
Self-pay price ranges
- Single session, self-pay
- $200 – $400
- Full 36-session course, self-pay
- $8,000 – $13,000
- Typical insured out-of-pocket
- Deductible + per-visit copay
- Initial mapping / brain mapping visit
- $300 – $500
Many Utah clinics offer payment plans or a discounted bundled rate for a full course — ask when you call.
Getting approved faster
- Bring a list of every antidepressant you have tried, with doses and how long you took them.
- Ask your prescriber to note the reason each medication was stopped — side effects count.
- Have a recent PHQ-9 or similar score on file; most insurers want a current measure.
- Let the clinic submit the authorization — their staff do this daily and know the templates.
- If you are denied, appeal. Denials for incomplete documentation are routinely overturned.
Looking for a clinic that takes your plan? Filter the directory by insurance.