Coverage
What TMS costs in Wisconsin and how insurers approve it
Nearly every major Wisconsin plan covers TMS for depression. The hold-up is almost never coverage — it is documentation.
Plan by plan
Anthem Blue Cross and Blue Shield (Wisconsin)
Generally covers TMS for treatment-resistant depression with prior authorization.
Quartz Health Solutions
Check plan behavioral health coverage; prior authorization typically required.
Dean Health Plan
Prior authorization typically required.
Security Health Plan
Check plan-specific coverage.
UnitedHealthcare
Commonly requires documented medication trials and prior authorization.
Cigna
Typically requires prior authorization for TMS.
Aetna
Typically requires prior authorization for TMS.
BadgerCare Plus (Wisconsin Medicaid)
Confirm coverage with your HMO.
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 Wisconsin 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.