Psychiatric Medicine Associates Psychiatric Medicine Associates
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Transcranial Magnetic Stimulation


TMS, or Transcranial Magnetic Stimulation, is a non-invasive magnetic stimulation device that helps to fill the gap in treatment options for patients who need relief from their depression but have not found success with medications and are reluctant to pursue other more invasive procedures like ECT.
TMS gently stimulates the brain through the skull using a magnet that is positioned over a small area of the brain called the Dorsolateral Prefrontal Cortex. This superficial area of the brain connects to many deeper brain structures and research suggests this stimulation improves depressive symptoms by increasing brain growth factors, modulating activity in deep structures of the brain implicated in depression, and supporting neuroplasticity (the brain’s ability to form and reorganize nerve pathways).


If depression is still taking hold of your life after at least 3 failed attempts of different medications, TMS may be the next best option for you. There are certain contraindications to TMS treatment, including metal plates and implants (with the exception of braces or dental fillings), surgical clips or sutures, hearing aids, history of seizures, etc. Our TMS providers will review a complete list of possible contraindications before administering treatment to ensure your safety.


  • PMA offers a full range of psychiatric care to ensure every patient receives a thorough and holistic experience during their treatment.
  • The highest level of attention to detail is given to each patient to ensure the highest quality of patient care, comfort, and safety.
  • PMA is home of Dr. Dave Avery – world-renowned developer and principal researcher for the Mag Venture TMS machine.
  Covered by Insurance Extensive Recovery Time Prep Time Systemic Side Effects Possible Dependency/Addiction Anesthesia/Meds Required for Treatment Invasive and/or Seizure Inducing
TMS x            
ECT x x x x   x  
Medication x     x x x  

*chance of seizure with TMS is approx 0.01%



Qualifying for Treatment:

Talk to your provider if you are interested in TMS treatment to see if it’s the right fit for you. Our TMS coordinator will authorize treatment with your insurance and get you on the books. If you are seeing a provider outside of PMA and you’re interested in TMS treatments here, reach out to our TMS coordinator using the Contact Box below to start the qualification process.

During TMS Treatments:

Initial appointments are approximately 1 hour. During this appointment, a medical provider will get you fitted with a cloth cap, mark the placement of the treatment site on the cap, and begin the first treatment. During the treatment, the patient is seated in a comfortable reclining chair. You are awake for the duration of the treatment and can relax by listening to music, watching a video, or chatting. Subsequent treatments only take approximately 19 minutes. The treatment sounds and feels like a tapping woodpecker on a small area of your scalp. Many patients report minor discomfort the first week or two, with the worst side effects being temporary scalp tenderness and headache. These symptoms generally subside within the first full week of treatment and can be treated with Tylenol or Ibuprofen. Patients generally report noticing a significant improvement in symptoms after about 4 weeks of consistent daily treatment.

 TMS is a FDA-approved treatment; therefore, several insurance companies cover TMS. Remember that all policies vary, and most require prior authorization, are plan specific, and your treatment may not be covered at 100%. We are contracted with Regence Blue Shield and Premera Blue Cross. The CPT codes used for TMS are 90867 ($425), 90868 ($275), and 90868 ($350). Our TMS coordinator will complete a complimentary benefits check with your insurance and complete the prior-authorization process for you. You may pay out of pocket for treatment if you do not have a qualifying insurance plan.



Check to see if TMS is a good fit before applying

  • Have tried and failed at least 3-to 4 medication trials?
  • Have received psychiatric or psychotherapy treatment/counseling?
  • Available for daily treatment M-F lasting on average 30 minutes
  • Do not have any contraindications to the treatments
  • Have a financial pathway for cost. You either have Premera, or Regence, or are able to self-pay. (9k-11k)

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Can I still take medication while doing TMS treatment?

Yes, patients may continue their normal medications while doing TMS simultaneously.

Is TMS approved during pregnancy?

Insurance coverage for TMS patients is subject to your specific plan and they may not approve treatment during pregnancy; however, TMS is safe for pregnant and breastfeeding mothers. There are no known side effects to either mother or baby. TMS might even be a preferred method of treating depression since standard medications are systemic and can affect the baby.

Is there an age requirement to receive TMS?

Patients of TMS must be at least 18 years of age or older.

What if my insurance doesn’t cover treatment?

No problem! We will still gladly serve you. You can look into your out-of-network benefits for reimbursement with your current insurance or choose from a self-pay payment plan for your treatment.

What is a typical course of treatment?

A full round of TMS treatment includes 30-40 sessions over a 4–6-week period. These sessions ideally happens every day, Monday through Friday. Each session usually lasts 20 minutes and can be scheduled during the workday. Patients can taper off treatment or start maintenance treatments after completing the first course of treatment at their provider’s discretion.

How do the treatments feel?

Many patients describe the sensation like a woodpecker tapping on a small, localized spot on the scalp. We provide patients with earplugs to protect their hearing from the tapping sound that comes from the magnetic coil during the stimulation pulses to increase comfort. Most patients report the tapping is the most uncomfortable during the first week of treatment, is much less intense the second week of treatment, and is barely noticeable after that. Some patients report twitching of the eye area, cheek, and jaw during the pulses as well, which are not painful.

How will I feel after each treatment?

Some patients report a very mild headache or scalp tenderness and warmth during the first week of treatment. These symptoms are temporary. There is no recovery time for TMS treatments, so patients can immediately resume their normal activities including driving and going to work directly after their daily appointments.

Is TMS safe?

Yes. TMS is a safe, effective, non-invasive, non-systemic, and FDA-approved treatment for treatment-resistant depression. It is currently being studied for more conditions including anxiety, fibromyalgia, OCD, Parkinson’s, and much more. There are no negative cognitive side effects to TMS.

How long do the results of TMS typically last?

Because of the various factors that influence each person's depression, there's no definitive answer to how long the TMS results will last. Most patients who complete the full course of treatment experience improvement in their symptoms for six months to a year or more.

Is TMS similar to Electroconvulsive Therapy (ECT)?

Both TMS and ECT work by stimulating specific areas of the brain that regulate mood. ECT uses electric currents to stimulate a seizure, while TMS uses a magnetic coil to stimulate a small area of the cortex. In most cases, it makes sense to try TMS first as it can improve brain function without cognitive side effects and does not require anesthesia. ECT requires sedation, recovery time, and a larger area of the brain is stimulated, which induces convulsions. TMS is less invasive -no recovery time is necessary; you can drive yourself home immediately after the appointment and resume your activities as you normally would.



Introduction to TMS

Patient FAQ