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Florida Blue Cross Blue Shield TMS Treatment and Therapy

Explore the transformative possibilities of Transcranial Magnetic Stimulation (TMS) treatment with your Florida Blue Cross Blue Shield (BCBS) coverage. Learn more about this innovative therapy and to what extent your health insurance provider covers this non-invasive brain stimulation for various mental health conditions. Learn about the comprehensive support Florida Blue and The Sylvia Brafman Mental Health Center provides.

What is TMS?

Transcranial Magnetic Stimulation (TMS) is a cutting-edge therapeutic technique involving the application of magnetic fields to stimulate specific brain regions. It’s used in the treatment of specific mental health conditions, notably major depressive disorder (MDD). Unlike traditional therapies, TMS is non-invasive, making it a well-tolerated option for individuals who may not respond to other forms of treatment or medication.

During TMS therapy sessions, a coil is placed on the scalp, delivering magnetic pulse stimulation to the targeted brain areas associated with mood regulation. This process modulates neural activity and promotes positive changes in brain function. Theta Burst Stimulation (TBS) is a pattern of neurostimulation techniques thought to induce alterations in cortical excitability and synaptic plasticity.

TMS is generally considered a safe, well-tolerated therapeutic intervention, but it may have some side effects like any medical procedure. Common TMS side effects are typically mild, including scalp discomfort or a mild headache at the treatment site during or after TMS therapy sessions. These effects tend to diminish as the treatment progresses, ensuring TMS efficacy and safety.

TMS has shown promising results in alleviating symptoms of depression, and research indicates its efficacy in reducing the severity of depressive episodes. As we delve deeper, you’ll discover specific statistics highlighting success rates, TMS side effects, and the overall impact of TMS as a transformative mental health treatment covered by Florida Blue Cross Blue Shield.1

Is TMS Therapy Evidence-Based?

While TMS may not be the first line of treatment for many conditions, this neuromodulation therapy is firmly grounded in a substantial body of scientific evidence, particularly in its effectiveness for treating major depressive disorder (MDD). Through TMS clinical trials, TMS has demonstrated its ability to alleviate depressive symptoms, especially for those who’ve not responded to conventional antidepressant medications.

The decision to pursue TMS treatment for depression or other mental health disorders is typically made collaboratively with healthcare professionals, taking into consideration your medical history and the severity of your condition. Below, we’ll continue to shed light on the specific conditions where TMS has a solid evidence base.

Approved by The FDA

Approved by The FDA

Transcranial Magnetic Stimulation (TMS) has received approval from the U.S. Food and Drug Administration (FDA) as a recognized, safe treatment for major depressive disorder (MDD). FDA-approved TMS is specifically for those who haven’t experienced significant improvement with traditional depression treatment(s), indicating the reliability and safety of TMS as a therapeutic option for addressing the challenges of MDD.

Moreover, the application of TMS extends beyond its FDA approval. Ongoing research and clinical trials are actively exploring the potential of TMS in treating various other conditions, such as anxiety disorders and post-traumatic stress disorder (PTSD). While further studies are needed to solidify its efficacy in these areas, the FDA’s initial approval of TMS and major depressive disorder (MDD) establishes TMS as a reputable, endorsed neuromodulation therapy, paving the way for its investigation and potential application in a broader spectrum of mental health disorders.2

Treatment Statistics Related to Transcranial Magnetic Stimulation (TMS)

Treatment Statistics Related to Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) has demonstrated clinical benefits for treatment-resistant depression, prompting suggestions for its evaluation as a potential first-line treatment for Major Depressive Disorder (MDD). Approximately 60% of patients with treatment-resistant depression show positive responses. High-dose TMS, tailored to individual needs, resulted in remission for 79% of participants with severe depression, showcasing its transformative potential.

In addition, TMS exhibits promise in migraine treatment, though more robust studies are needed for conclusive evidence. In neurological disorders, TMS combined with physical therapy reduces spasticity in Multiple Sclerosis. Its integration with cognitive processing therapy effectively treats PTSD, with sustained benefits for six months. A 2019 study suggests TMS may reduce anxiety-related nerve cell activity in the prefrontal cortex. These findings underscore the broad therapeutic potential of TMS across diverse mental health conditions and neurological disorders.

>Is TMS Therapy Evidence-Based?

Who is Florida Blue?

The Blue Cross Blue Shield Association (BCBSA) is a collection of independent health insurance companies that assist people throughout the United States. One of its prominent subsidiaries is Florida Blue, which was founded in 1945. Florida Blue is a health insurance provider that offers comprehensive health coverage options and preventive care benefits to residents of Florida.

With a solid commitment to improving the health and well-being of the community, Florida Blue remains a vital player in the healthcare landscape. It has become the country’s largest single-state provider of individual marketplace plans.3

Some BCBS Brands, Products, and Services

Some BCBS Brands, Products, and Services

The BCBS network offers a diverse range of brands, products, and services to cater to the healthcare needs of millions of Americans. These entities are region-specific and provide inclusive health insurance solutions, including individual and group plans, Medicare alternatives, and advanced wellness and mental health solutions.

  • Florida Blue, the Blue Cross Blue Shield (BCBS) entity dedicated to Florida residents, provides a range of health insurance plans. These include PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization) options, along with services like Health Savings Accounts (HSAs). Florida Blue caters to the needs of individuals, families, and businesses, ensuring access to diverse healthcare coverage and financial solutions.
  • The BlueCard Program provides access to healthcare providers outside the Florida Blue service area, ensuring peace of mind.4
  • BlueOptions presents various health coverage options featuring diverse coverage levels and networks, encompassing both in-network and out-of-network coverage.5
  • BlueSelect offers a healthcare network of in-network providers and cost-effective options.
  • BlueCare provides convenience and affordability, heavily emphasizing preventive care and early diagnosis to manage costs predictably via established copayments.
  • BlueMedicare offers Medicare Advantage plans, Medicare Supplement (Medigap) plans, and prescription drug coverage for eligible beneficiaries in Florida.
  • Better You Strides rewards program supports members in improving their overall well-being, addressing physical and emotional wellness. Members have the flexibility to tailor their health journey, aligning it with their individual needs, goals, and interests.6
  • MyBlue Health supports the insured in managing health, chronic conditions, and healthcare expenses, like insurance premiums.

>Who is Florida Blue?

At The Sylvia Brafman Mental Health Treatment Center in Fort Lauderdale, Florida, our team of dedicated professionals is ready to guide you. We offer IOP and a variety of treatments programs, each uniquely designed to meet your needs. So don’t wait, reach out to us today! Either give us a call or fill up the form below to request a callback.

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Does Florida Blue Cross Blue Shield Cover Transcranial Magnetic Stimulation?

Florida Blue provides coverage for Transcranial Magnetic Stimulation (TMS) when medically necessary. As a forward-thinking health insurance provider, Florida Blue recognizes the significance of innovative treatments for mental health conditions. Individuals seeking TMS therapy for disorders such as major depressive disorder can benefit from the coverage and support offered by Florida Blue, facilitating access to this transformative treatment option.7

To learn more about TMS at our South Florida-based mental health and substance abuse treatment center, call 877-958-9212. Our helpful patient advocates can provide details on your Florida Blue Insurance plan, including copayments, deductibles, limitations, exclusions, and more.

Does Florida Blue Cross Blue Shield Cover TMS Therapy for Depression Treatment?

Yes, Florida Blue covers TMS therapy as part of its comprehensive approach to mental health coverage. TMS is a covered therapeutic option under Florida Blue for medically necessary circumstances. With a commitment to supporting mental health, Florida Blue helps individuals on their journey to well-being and recovery by including TMS therapy in their coverage for major depressive disorder (MDD).

It is essential to review your policy documents to understand coverage details fully. If you need guidance or assistance, you can call 877-958-9212. Seeking professional help is a crucial and admirable first step. Understanding your mental health insurance coverage ensures that you have access to the necessary resources for effective depression treatment.

>Does Florida Blue Cross Blue Shield Cover TMS Therapy for Depression Treatment?

Florida Blue May cover TMS Therapy for The Following Conditions

Florida Blue may cover TMS therapy for specific conditions, offering an alternative for individuals unresponsive to standard, first-line treatments. The “maybe” reflects the individualized approach in considering TMS, acknowledging that it may not always be an appropriate first choice. The following will elaborate on conditions where TMS is potentially covered, highlighting its role in treating an array of diverse conditions.

TMS and Major Depressive Disorder (MDD) Treatment

TMS and Major Depressive Disorder (MDD) Treatment

Transcranial Magnetic Stimulation (TMS) is an innovative, non-invasive treatment that is FDA-approved for treating Major Depressive Disorder (MDD). In this therapeutic approach, magnetic pulse stimulation is used in targeted areas of the brain associated with mood regulation. TMS for MDD treatment is often recommended when traditional treatments like medication or psychotherapy have not yielded satisfactory results.

Notably, Florida Blue typically covers TMS for treating MDD, recognizing its efficacy and potential as a transformative solution for individuals facing challenges with depressive symptoms. The coverage extends support to those seeking an innovative therapeutic approach, fostering accessibility and exhibiting promising results in alleviating the impact of depression on mental well-being.

TMS and Obsessive-Compulsive Disorder (OCD) Treatment

TMS and Obsessive-Compulsive Disorder (OCD) Treatment

Findings from ongoing clinical studies and evolving insights into the impact of TMS on brain networks associated with OCD are promising.8 In 2018, the FDA approved the use of TMS in treating OCD.9 Similar to its application in depression, TMS is suggested for individuals with OCD who haven’t shown positive responses to medication and psychotherapy.

These neurostimulation techniques aim to reduce the impact of obsessive thoughts and compulsive behaviors. Typically, and when medically necessary, Florida Blue covers TMS treatment for OCD, recognizing its potential as an effective intervention for those struggling with OCD symptoms. This coverage underscores Florida Blue’s commitment to providing accessible, comprehensive mental health solutions, ensuring individuals have the support they need in exploring innovative therapies for OCD management.

TMS and Bipolar Depression Disorder Treatment

TMS and Bipolar Depression Disorder Treatment

TMS serves as a non-invasive treatment option for bipolar disorder, targeting specific brain regions to modulate neural activity and manage mood fluctuations. Transcranial magnetic stimulation shows promise as a viable treatment approach for individuals with bipolar disorder who haven’t responded to pharmacological or psychosocial interventions.10
Typically covered by Florida Blue, TMS for bipolar disorder underscores BCBS’ commitment to providing accessible and effective interventions for individuals facing the complexities of this condition.

TMS for Post-Traumatic Stress Disorder (PTSD) Treatment

TMS for Post-Traumatic Stress Disorder (PTSD) Treatment

TMS is a promising treatment option for individuals struggling with PTSD. This treatment targets specific areas of the brain that are associated with PTSD symptoms, aiming to modulate neural activity and alleviate the impact of trauma-related stress. TMS is typically considered when conventional interventions fail to provide relief, offering an alternative approach for individuals seeking effective, well-tolerated solutions for symptoms.

Preliminary studies indicate promising effects for Post-Traumatic Stress Disorder (PTSD) when combining Transcranial Magnetic Stimulation (TMS) with psychotherapy.11 Florida Blue typically covers TMS for the treatment of PTSD, recognizing its potential as an impactful intervention for individuals grappling with trauma’s complex effects.

TMS for Borderline Personality Disorder Treatment

TMS for Borderline Personality Disorder Treatment

TMS is emerging as a potential avenue for treating BPD. This method involves applying magnetic fields to specific brain regions linked to BPD symptoms. The brain connectivity modulation aims to address the unique challenges posed by BPD. TMS for BPD treatment is considered an alternative when conventional approaches, such as psychotherapy or medications, don’t provide adequate relief.

The available research suggests that repetitive transcranial magnetic stimulation (rTMS) is a well-tolerated treatment for individuals with borderline personality disorder.12 Typically, Florida Blue offers coverage for TMS for treating BPD under medically necessary circumstances, acknowledging its potential as an effective intervention for dealing with the complexities of this condition. This coverage ensures individuals have the support to explore innovative, evidence-based therapies.

TMS for Auditory Hallucinations in Schizophrenia Treatment

TMS for Auditory Hallucinations in Schizophrenia Treatment

There is an indication that applying low-frequency transcranial magnetic stimulation (TMS) to the left temporoparietal cortex may potentially decrease the frequency and intensity of auditory hallucinations in individuals with schizophrenia.13 This part of the brain is involved in language and is typically overactive in schizophrenia.14

TMS for the treatment of auditory hallucinations in schizophrenia is considered when traditional interventions, such as antipsychotic medications or psychotherapy, don’t provide sufficient relief. Florida Blue usually covers TMS for the treatment of auditory hallucinations in schizophrenia when medically necessary.

>Florida Blue May cover TMS Therapy for The Following Conditions

TMS Center in Florida That Accepts Blue Cross Blue Shield Insurance

The Sylvia Brafman Mental Health Center provides comprehensive mental health care services, which include transcranial magnetic stimulation (TMS). TMS involves daily sessions for a few weeks, is well-tolerated, and doesn’t require anesthesia. This makes it an excellent option if you prefer not to use antidepressant medications or undergo invasive procedures.

With decades of collective expertise, our skilled medical and clinical teams have effectively aided thousands in navigating and conquering mental health hurdles. Additionally, there’s a possibility that we accept your Florida Blue Insurance policy, increasing accessibility to our services for those requiring assistance. For further information about our offerings, please contact us at 877-958-9212 or visit our physical location as detailed below:

>TMS Center in Florida That Accepts Blue Cross Blue Shield Insurance

How Much Does TMS Treatment Cost Without BCBS Insurance?

The cost of a single course of transcranial magnetic stimulation can range from $6,000 to $12,000 without insurance. Before your health insurance provider offers coverage, you may have to meet specific criteria, such as adverse reactions, after trying at least two to four antidepressants.1516 TMS must also be deemed medically necessary by a qualified healthcare professional.

For an accurate evaluation of your expenses for TMS treatment in Florida, call 877-958-9212.

>How Much Does TMS Treatment Cost Without BCBS Insurance?

How To Get BCBS To Pay for TMS Therapy in Florida?

To begin obtaining coverage for TMS therapy in Florida, start by clearly understanding your Florida Blue Insurance plan and its associated coverage particulars. Call 877-958-9212 for assistance in navigating the complexities of TMS treatment for depression and other disorders and answers to your most pressing questions.

Once you understand your coverage specifics and requirements, collaborate closely with healthcare professionals and treatment centers. Ensure direct communication with Florida Blue to secure prior authorization for your proposed treatment plan. This proactive engagement aids in expediting the approval process and mitigating the risk of your health insurance provider denying claims.

TMS Treatment-Related Statistics

TMS Treatment-Related Statistics

  • The reported clinical benefits from both patients and clinicians after routine Transcranial Magnetic Stimulation (TMS) for treatment-resistant depression are comparable to alternative interventions. Given its robust efficacy and minimal side effects or medical risks, there is a suggestion to consider evaluating TMS as a potential first-line treatment for Major Depressive Disorder (MDD).17
  • It has been found that around 60% of patients suffering from treatment-resistant depression show positive responses to TMS therapy.18
  • In a meticulously conducted double-blind controlled study, the application of high doses of magnetic brain stimulation, administered on an expedited schedule and tailored to individual needs, led to remission in 79% of participants facing severe depression.19
  • Using TMS for migraine treatment might help reduce the intensity and frequency of attacks, and it seems safe to use. However, the evidence supporting this is not very strong or conclusive because of flaws in study methods and differences among the existing studies.20
  • In a study from 2019, researchers applied TMS to the motor cortex of individuals with Multiple Sclerosis (M.S.). The combination of this treatment with physical therapy was observed to result in a reduction in spasticity.21
  • In a trial conducted in 2018, it was discovered that combining TMS with cognitive processing therapy proved effective for treating post-traumatic stress disorder (PTSD). The positive therapeutic effects of this integrated approach were sustained for six months.22
  • According to a study from 2019, increased nerve cell activity in the prefrontal cortex, commonly seen in anxiety, could potentially be reduced by TMS.22

Sources

Sources

  1. Mayo Foundation for Medical Education and Research (MFMER). “Transcranial Magnetic Stimulation.” Mayo Clinic, www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwj0vLmTiPyCAxWoJUQIHdh9BHYQFnoECBMQAQ&url=https%3A%2F%2Fwww.mayoclinic.org%2Ftests-procedures%2Ftranscranial-magnetic-stimulation%2Fabout%2Fpac-20384625&usg=AOvVaw1uHvp_YZ4FoY5IzJArSI_i&opi=89978449. Accessed 6 Dec. 2023.
  2. “Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults With Major Depressive Disorder (L34522).” Centers for Medicare & Medicaid Services, www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=34522&ver=29. Accessed 6 Dec. 2023.
  3. “Our Story | History and Information | Florida Blue.” Florida Blue, www.floridablue.com/about-us/our-story. Accessed 5 Dec. 2023.
  4. “The BlueCard Program.” Florida Blue | Blue Cross Blue Shield, www.floridablue.com/sites/floridablue.com/files/BlueCard+Program+Brochure.pdf. Accessed 12 Sept. 2023.
  5. Blue Cross Blue Shield Association. “BlueOptions: Enrollment Guide for Group Employees.” Blue Cross Blue Shield Florida, www.bcbsfl.com/DocumentLibrary/SalesCommunications/content/Enrollment%20Guide%20for%20Group%20Employees%20-%20BlueOptions%20-%20National%20Rx%20(English).pdf. Accessed 11 Sept. 2023.
  6. “Better You Strides | Rewards Program | Florida Blue.” Florida Blue, www.floridablue.com/individualsandfamilies/better-you-strides-rewards-program. Accessed 11 Sept. 2023.
  7. “Subject: Transcranial Magnetic Stimulation.” Blue Cross Blue Shield of Florida, 22 Mar. 2023, mcgs.bcbsfl.com/MCG?mcgId=01-93875-18&pv=false.
  8. Cocchi, Luca, et al. “Transcranial Magnetic Stimulation in Obsessive-compulsive Disorder: A Focus on Network Mechanisms and State Dependence.” NeuroImage: Clinical, vol. 19, Jan. 2018, pp. 661–74. https://doi.org/10.1016/j.nicl.2018.05.029.
  9. Office of the Commissioner. “FDA Permits Marketing of Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder.” U.S. Food And Drug Administration, 17 Aug. 2018, www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder.
  10. Gold, Alexandra K., et al. “Clinical Applications of Transcranial Magnetic Stimulation in Bipolar Disorder.” Brain and Behavior, vol. 9, no. 10, Sept. 2019, https://doi.org/10.1002/brb3.1419.
  11. Petrosino, Nicholas, et al. “Transcranial Magnetic Stimulation for Post-traumatic Stress Disorder.” Therapeutic Advances in Psychopharmacology, vol. 11, Jan. 2021, p. 204512532110499. https://doi.org/10.1177/20451253211049921.
  12. Konstantinou, Gerasimos, et al. “Repetitive Transcranial Magnetic Stimulation in Patients With Borderline Personality Disorder: A Systematic Review.” Psychiatry Research, vol. 304, Oct. 2021, p. 114145. https://doi.org/10.1016/j.psychres.2021.114145.
  13. McIntosh, Andrew M., et al. “Transcranial Magnetic Stimulation for Auditory Hallucinations in Schizophrenia.” Psychiatry Research, vol. 127, no. 1–2, June 2004, pp. 9–17. https://doi.org/10.1016/j.psychres.2004.03.005.
  14. Marzouk, Taylor, et al. “Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review.” Neuropsychobiology, vol. 79, no. 6, Sept. 2019, pp. 384–96. https://doi.org/10.1159/000502148.
  15. Nunez, Kirsten. “What You Need to Know About Transcranial Magnetic Stimulation (TMS) Therapy.” Healthline, 20 Jan. 2021, www.healthline.com/health/tms-therapy#costs.
  16. Bermudes, Richard A. “Guidance on Navigating Insurance Plans for TMS-Eligible Patients.” Psychiatric News, vol. 56, no. 10, Sept. 2021, https://doi.org/10.1176/appi.pn.2021.10.36.
  17. Sackeïm, Harold A., et al. “Clinical Outcomes in a Large Registry of Patients With Major Depressive Disorder Treated With Transcranial Magnetic Stimulation.” Journal of Affective Disorders, vol. 277, Dec. 2020, pp. 65–74. https://doi.org/10.1016/j.jad.2020.08.005.
  18. “Transcranial Magnetic Stimulation (TMS).” University of Florida Health Jacksonville, ufhealthjax.org/conditions-and-treatments/transcranial-magnetic-stimulation-tms. Accessed 6 Dec. 2023.
  19. “Experimental Depression Treatment Is Nearly 80% Effective in Controlled Study.” News Center, 28 Oct. 2021, med.stanford.edu/news/all-news/2021/10/depression-treatment.html.
  20. Shen, Min, et al. “Transcranial Magnetic Stimulation as a Therapy for Migraine: An Overview of Systematic Reviews.” Journal of Pain Research, vol. Volume 16, Sept. 2023, pp. 3133–44. https://doi.org/10.2147/jpr.s416993.
  21. Şan, Ayça Uran, et al. “The Effect of Repetitive Transcranial Magnetic Stimulation on Spasticity in Patients With Multiple Sclerosis.” The Journal of Clinical Neurology, vol. 15, no. 4, Jan. 2019, p. 461. https://doi.org/10.3988/jcn.2019.15.4.461.
  22. Kozel, F. Andrew, et al. “Repetitive TMS to Augment Cognitive Processing Therapy in Combat Veterans of Recent Conflicts With PTSD: A Randomized Clinical Trial.” Journal of Affective Disorders, vol. 229, Mar. 2018, pp. 506–14. https://doi.org/10.1016/j.jad.2017.12.046.
  23. Balderston, Nicholas L., et al. “Mechanistic Link Between Right Prefrontal Cortical Activity and Anxious Arousal Revealed Using Transcranial Magnetic Stimulation in Healthy Subjects.” Neuropsychopharmacology, vol. 45, no. 4, Dec. 2019, pp. 694–702. https://doi.org/10.1038/s41386-019-0583-5.

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