If you've tried two or more antidepressants and still don't feel like yourself, you're not out of options. And if you carry a Cigna plan, there's a good chance your insurance will help pay for TMS therapy.
At California TMS Clinics in Santa Monica, we treat Cigna members with NeuroStar® Advanced TMS Therapy, an FDA-cleared, non-drug treatment for depression. Our team checks your benefits, gathers your records and submits the prior authorization for you. You focus on getting better. We handle the paperwork.
Free benefits check. No obligation. Fast turnaround from our Santa Monica clinic.
Yes. Cigna covers TMS therapy for major depressive disorder when it is medically necessary and prior authorized. Under Cigna/Evernorth Coverage Policy EN0383 (effective March 15, 2026), Cigna covers an initial course of 30–36 TMS sessions for people aged 15 and older with moderate-to-severe depression who have not improved after two antidepressant trials and a course of psychotherapy. Cigna also covers repeat courses for relapse, and deep TMS for OCD in adults.
| Quick Fact | Cigna's 2026 Rule |
|---|---|
| Covered conditions | Major depressive disorder; OCD (deep TMS only) |
| Minimum age | 15 for depression; 18 for OCD |
| Sessions per course | 30–36 sessions |
| Prior authorization | Required before first session |
| Medication history | 2 failed antidepressant trials (adults: from 2 different classes) |
| Therapy history | An adequate trial of evidence-based psychotherapy |
| Not covered | Maintenance TMS; SAINT and other accelerated protocols |
Source: Cigna/Evernorth Coverage Policy EN0383 (Effective March 15, 2026)
TMS (transcranial magnetic stimulation) uses focused magnetic pulses to wake up the parts of the brain that go quiet during depression. It's the same kind of magnetic field used in an MRI, aimed at one small area: the left dorsolateral prefrontal cortex, which helps regulate mood.
You stay awake the whole time. There's no anesthesia, no sedation and no downtime, so most people drive themselves home and go straight back to work. A standard course is one short session a day, five days a week, for about six weeks.
Depression is common, and medication doesn't work for everyone. An estimated 21 million U.S. adults, about 8.3%, had a major depressive episode in a single year (NIMH). For people who've tried several antidepressants without relief, insurers like Cigna now see TMS as an accepted, evidence-based next step. Cigna's own policy notes that some studies found TMS outcomes comparable to ECT, with fewer side effects.
Cigna approves TMS when your records show you meet all of the requirements below. These come from Cigna/Evernorth Coverage Policy EN0383, effective March 15, 2026. Read through the list. If most of it sounds like you, you're probably a strong candidate.
Cigna lowered its age floor from 18 to 15 for depression, matching the FDA clearance for teens.
Moderate to severe depression, single or recurrent, and without psychosis.
Adults: 2 failed trials from 2 different drug classes (e.g. SSRI + SNRI). Teens 15–17: 2 failed trials of any kind.
An adequate course of evidence-based psychotherapy, such as CBT, during this episode without real improvement.
A validated scale such as the PHQ-9 is administered at the start and end of each course. (We do this for you).
Not sure about your history? You don't need perfect records. Our team requests notes and builds the file for you.
Either you took the drug at a proper dose for at least four weeks without meaningful relief, or you couldn't tolerate it, or a medical reason stopped you from taking it. Side effects count. You don't have to suffer through a medication to qualify.
If depression comes back, Cigna will approve another 30–36 sessions when both of these are true:
Cigna also covers deep TMS for adults 18+ with obsessive-compulsive disorder who have failed two OCD medications (each tried for at least eight weeks) and a course of therapy. Y-BOCS scores are tracked at the start and end. Ask us whether we can refer you to a deep TMS provider for OCD.
| Treatment | Cigna's Position (2026) |
|---|---|
| Maintenance TMS (ongoing sessions after a successful course) | Not medically necessary |
| SAINT / Stanford Neuromodulation Therapy | Experimental, not covered |
| Accelerated or theta-burst protocols | Experimental, not covered |
| TMS for anxiety alone, PTSD, bipolar depression, migraine, etc. | Not covered |
| At-home TMS | Not covered |
The good news: standard NeuroStar TMS for depression, the treatment we provide, is exactly what Cigna covers.
Cigna requires prior authorization before TMS starts. That's the step where most people get stuck, so we take it off your plate. Here's how it works at California TMS Clinics:
Fill out our short form or call (310) 340-6062. Have your member ID card handy.
We contact Cigna or Evernorth Behavioral Health to confirm your coverage, deductible and copay.
Dr. Troggio performs a face-to-face evaluation to confirm the diagnosis and ensure TMS is safe for you.
We gather medication history, therapy notes and depression scores exactly as Cigna reviewers expect.
We submit everything directly to Cigna/Evernorth and track the case until approved.
Once approved, we book your mapping session and daily appointments around your schedule.
Card Tip: Look at the back of your Cigna card. If it lists a separate behavioral health or Evernorth number, that's the team that reviews TMS requests. Share it with us to speed things up!
With an approved prior authorization, most Cigna members pay only their normal plan cost share, not the full price of TMS. What you owe depends on four numbers in your plan:
| Plan Term | What It Means For Your TMS Course |
|---|---|
| Deductible | What you pay before Cigna starts sharing costs. If you've already met it this year, your costs drop right away. |
| Copay | A flat fee per visit, such as a specialist copay, on some plans. |
| Coinsurance | A percentage you pay after the deductible, such as 20%. |
| Out-of-pocket maximum | Your yearly ceiling. Once you hit it, Cigna pays 100% of covered in-network care for the rest of the plan year. |
*For 2026, federal law caps in-network out-of-pocket costs on ACA-compliant plans at $10,600 for an individual and $21,200 for a family (HealthCare.gov). Many Cigna plans set their limit well below that.
A denial isn't the end of the road. Many TMS denials come down to missing paperwork, such as a medication dose or therapy dates that weren't documented. Those are fixable.
*Not sure which rules apply to you? Your plan type is printed on your Cigna card. We'll help you figure it out.
You deserve a clinic that treats your depression like it matters and treats your insurance like it's their job, because it is.
Treatment is overseen by Dr. Torey Troggio, a board-certified psychiatrist with specialized NeuroStar TMS training. Cigna requires a qualified, board-certified physician.
As part of Los Angeles Therapy Institute, we coordinate the psychotherapy Cigna asks for, so your records tell one clear, coherent story.
Benefits check, medical records gathering, prior authorization submission, tracking, follow-up, and appeal management.
NeuroStar is the premier TMS system behind more than one million successful depression treatments worldwide.
Conveniently located in Santa Monica, serving West Los Angeles, Beverly Hills, Pacific Palisades, and the wider Westside.
Zero waitlists. Begin your psychiatric consultation and start your TMS treatment plan as soon as next week.
Everything you need to know about Cigna / Evernorth policy EN0383, sessions, costs, and eligibility:
Yes. Cigna covers TMS for moderate-to-severe major depressive disorder when it's prior authorized and you've had two failed antidepressant trials plus an adequate course of psychotherapy. Coverage is set out in Cigna/Evernorth policy EN0383.
Cigna approves 30–36 sessions per course, usually one a day over four to six weeks, including taper sessions. Repeat courses of 30–36 sessions may be approved if depression returns.
Yes. TMS must be approved by Cigna before your first session. California TMS Clinics prepares and submits the prior authorization request for you.
Yes, as of March 2026. Cigna covers TMS for depression starting at age 15 when the teen has failed two antidepressant trials and a course of therapy. Contact us to confirm adolescent intake availability at our Santa Monica clinic.
Yes, for adults 18 and older, using deep TMS on an FDA-cleared device. You need two failed OCD medication trials of at least eight weeks each and a course of therapy.
No. Cigna classifies SAINT, Stanford Neuromodulation Therapy, theta-burst and other accelerated protocols as experimental. Standard daily TMS, like NeuroStar, is covered.
No. Ongoing maintenance sessions after a successful course aren't covered. A full repeat course can be covered if symptoms return after at least two months of improvement.
No. Many people stay on their medication during TMS. Your psychiatrist will review your prescriptions to make sure they're safe alongside treatment.
Evernorth Health Services is part of The Cigna Group. On many Cigna plans, Evernorth Behavioral Health manages mental health benefits and reviews TMS requests.
You can request a peer-to-peer review, file an internal appeal (generally within 180 days) and then ask for an independent review. California residents on state-regulated plans can request a free Independent Medical Review through the DMHC.
You've already done the hard part by trying medication and therapy. Let us handle the next step. A free benefits check takes a few minutes of your time and tells you exactly where you stand.
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