Watch KCRA channel 3, Wednesday March 14th at 4 pm for a report on our newest treatment for depression- transcranial magnetic stimulation (TMS). The show will feature a TMS physician and a patient, who has benefited from this effective non-pharmacological approach to treatment resistant depression. Sacramento TMS is the first provider of TMS therapy for depression in the Sacramento region. Our first TMS center opened in February 2010 in El Dorado Hills. Our second center opened in Sacramento in October 2011.

KCRA will also interview one of our patients who has benefited from this treatment. Our patient had suffered from depression for many years prior to receiving TMS therapy. She had tried multiple medications, suffered multiple side effects and had only achieved partial results at best with the medications prescribed by her psychiatrist. TMS has truly changed the course of her depression and she now is in recovery and enjoying a quality of life that she has not experienced in years!

Tune into KCRA Channel 3 at 4 pm Wednesday March 14th to learn more about TMS on the Dr. Oz show. Our patent’s story will be broadcast on KCRA.

Do a google search on “drug free depression treatment” and a million web sites will come up including google ads touting the problems with antidepressants and ways to beat depression without taking medications. Some of these sites talk about TMS therapy for depression. Neuronetic’s site states that its treatment is for “patients trapped by depression and its treatment side effects.” Many patient testimonies about TMS include extensive histories of medication trials that did not work, or in fact made the person worse. Taken as whole TMS would appear to be a great treatment option for depression for patients who do not want to try medication or who have not responded to medication or suffered from medication side effects.

So is TMS really a medication free approach to treat depression?

In short yes and no.

TMS is a brain treatment that uses magnetic pulses to stimulate a specific part of the brain associated with depression, the left prefrontal cortex. It is not a treatment that works by ingesting a chemical that gets to the brain by absorption into the blood stream and then crossing the blood-brain barrier. In this way TMS is truly a drug-free method of treating the brain.

TMS does not cure the brain of depression. This means that we have no data to suggest that if a person responds to a course of TMS therapy that they will not have depression in the future. In fact we do not have a treatment modality that seems to cure depression in the majority of patients, especially patients who have had 2 or more depressive episodes. This goes for other drug-free treatments, including ECT and psychotherapy.

Since we don’t have a cure for depression we have to ask “once the depression is treated how do we maintain remission?” When treating patients with severe depression or multiple episodes patients do better with a maintenance therapy (they have less depression and depressive relapses). So once we have completed TMS therapy for depression we have to look at maintenance treatment to keep the patient in remission. This treatment can include medications, continuation TMS or psychotherapy. Certainly, combinations of these treatments can help patients maintain the results from TMS.

At Sacramento TMS we can offer a truly medication-free approach to treat depression. We offer TMS for the acute phase of treatment and once the depression is in remission we offer continuation treatment with TMS. We also offer cognitive-behaioral therapy and mindfulness meditation approaches to maintaining remission as these methods have both been found to improve remission rates from depression.

Antidepressant medications are also very effective in helping patients maintain remission. For those patients who do not have treatment side effects from antidepressant medications, they are very effective at reducing relapse rates.

Sacramento TMS is pleased to announce the opening of a second treatment center in Sacramento beginning the first week of December. Our second office is located in the Campus Commons area (Howe and Hwy. 50) at 350 University Avenue, Suite 101, Sacramento California. Now TMS therapy for depression is close and accessible to the following Sacramento communities: Davis, West Sacramento, Natomas, Elk Grove, Fair Oaks, Carmichael, and Roseville.

Sacramento TMS offers specialized treatments for major depression in the Sacramento region. Sacramento TMS is the first provider of TMS therapy (transcranial magnetic stimulation), a FDA approved treatment for patients with depression who not have responded to antidepressant medication. Sacramento TMS began treating patients with transcranial magnetic stimulation in 2010 in El Dorado Hills. This center brings TMS therapy to patients and is conveniently located near the Sacramento communities of Folsom, Granite Bay, Cameron Park, and Placerville.

To learn more about TMS therapy for depression in Sacramento California contact our TMS program coordinator at (916) 932-0375. Sacramento psychiatrists and Sacramento psychologists who want to learn more about transcranial magnetic stimulation in the Sacramento region can call and consult our TMS psychiatrist.

“How much does TMS cost?” A year ago (April 2010) I posted this blog entry and it is by far the most visited post to date. “How much does TMS cost?” is still the most common question we get when we get an inquiry- whether it is from another provider referring a potential client or a potential client asking about the treatment.

A year ago all of our clients who underwent TMS for depression paid “out of pocket” for the TMS. That is, they considered the cost of TMS versus the cost of their depression and made the decision to pay for the treatment. In 2011 we have seen a completely different landscape in reimbursement for TMS. The majority of our clients at Sacramento TMS are getting commercial insurance to cover their TMS treatment. Currently we have clients receiving coverage from Cigna, MHN (Managed Health Network, a subsidiary of Health Net), Magellan (provides behavioral health coverage for Western Health Advantage members in Sacramento),  the Blue Shield/Blue Cross Federal Program, Blue Shield of California, and Anthem Blue Cross.

With each of these clients the path to securing coverage has been quite different. Some of these authorizations were quite simple requiring some basic paperwork to be completed while other authorizations took months, requiring extensive appeals.

At Sacramento TMS we are committed to the reimbursement process. Our goal is to reduce any costs or barriers you face when deciding if TMS is the appropriate treatment for you.

Sacramento TMS Wins TMS Reimbursement For Patient with Anthem Blue Cross Insurance

Although the FDA approved TMS (transcranial magnetic stimulation) for the treatment of depression in patients who have not responded to one antidepressant trial and the American Psychiatric Association (APA) included TMS in its treatment guidelines for the treatment of depression, some commercial insurance companies have not adopted TMS as a covered medical procedure. Anthem Blue Cross of California is one such carrier that still considers TMS to be investigational despite the FDA and APA approvals. (see the following link for Anthem’s policy and rationale: http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a047769.htm)

Despite Anthem’s stance, Sacramento TMS recently won reimbursement by appealing Anthem’s denials. After Anthem’s second denial we had an opportunity to appeal the policy decision to an external reviewer. In the state of California external reviewers are hired by the state (not the insurance companies) to independently and impartially review negative coverage decisions by insurance companies. In this case, the patient had completed TMS treatment and Sacramento TMS had submitted claims to Anthem for reimbursement. These claims were initially denied as Anthem considers TMS to be an “investigational medical procedure,” and therefore as “investigational” not eligible for reimbursement. Fortunately two of the three independent reviewers sided with the patient and Sacramento TMS and Anthem’s initial denials were overturned!

Nationally we are seeing a trend in favor of coverage decisions for TMS. At Sacramento TMS we partner with clients to aggressively pursue insurance reimbursement. We believe in taking cases all the way to external review so more patients have access to TMS. We believe TMS is an evidence-based treatment. As an FDA cleared treatment, TMS should be accessible to patients just as antidepressants, psychotherapy and ECT are covered treatments for depression. If we  continue to advocate with our clients for coverage, these policies which ignore the FDA and APA’s endorsements will be considered outdated policies of the past.