- Joined
- Sep 28, 2015
- Messages
- 3,185
- Reaction score
- 3,971
I'm a psychiatry-matched MS4 currently on a pain clinic elective. I am giving a presentation about some RCTs of TMS for chronic pain conditions and would like to include some basics about reimbursements for TMS in general. I'm aware that it's not currently billable for pain (except migraines), but the goal is to provide some background about the reimbursement landscape for approved conditions.
I've scoured some old threads and found the following info thus far:
A few specific questions that I have:
1. Do these numbers look like they are in the ballpark for what you currently see?
2. Do the machines have some sort of use fee (like uro lasers or PRK machines where you pay a fee per use in addition to initial equipment costs).
3. Any anecdotal accounts of pts treated for an approved condition that also had some comorbid chronic pain condition where the reported to you that the pain condition was better after TMS.
I've scoured some old threads and found the following info thus far:
- 2022 thread:
- Attending #1 (academic setting)
- Dept of VA uses Fairhealth’s metrics for total RVU’s for TMS
- CPT 90857 = 8.31
- Initial session
- CPT 90868 = 6.22
- Subsequent sessions
- CPT 90869 = 8.67
- Subsequent session w/ remapping
- $1000 by one major insurer
- Subsequent session w/ remapping
- CPT 90857 = 8.31
- Dept of VA uses Fairhealth’s metrics for total RVU’s for TMS
- Attending #2
- Intake wRVU = 2
- f/u wRVU = 1.5
- Attending #1 (academic setting)
- 2023 thread:
- Northstar rep stated that a practice needs 2-3 pts per day to cover ROI in 1st year, then 1 per day in subsequent yrs
- 2012 thread: Reimbursements anywhere from $184 to $400 per session. 20-30 sessions are considered a full course. Cash price for entire treatment course $8k-$12k
A few specific questions that I have:
1. Do these numbers look like they are in the ballpark for what you currently see?
2. Do the machines have some sort of use fee (like uro lasers or PRK machines where you pay a fee per use in addition to initial equipment costs).
3. Any anecdotal accounts of pts treated for an approved condition that also had some comorbid chronic pain condition where the reported to you that the pain condition was better after TMS.