Frequently Asked TMS Questions

Are you accepting new TMS patients?
Yes.


Do I need a referral from another doctor or provider for TMS?
No, however a written referral from your primary care provider or therapist facilitates communication and coordination of your medical care.


Does insurance pay for TMS?
Most insurance companies pay for TMS therapy if a person has a diagnosis of Major Depressive Disorder, Single Episode, Severe (F32.2) or Major Depressive Disorder, Recurrent, Severe (F33.2) and meets the medical necessity criteria specific to their insurance company.


What insurance do you accept?
We accept and direct bill the following insurance plans: Blue Cross and Blue Shield of Montana, Cigna/Allegiance and Pacific Source.  For other insurance plans, we work with patients in developing an out-of-pocket payment plan. 


How much will my care cost?
We are happy to discuss rates for our services with you and help you determine your overall cost of treatment and the amount that your insurance will cover.  Our team will coordinate with your in-network insurance company prior to the start of treatment.


How long do TMS treatments last and how long is the overall course of treatment?

The active TMS therapy lasts 20 minutes per session, however the overall length of each visit/appointment varies.  The first treatment session usually lasts 60-90 minutes and subsequent TMS treatment sessions typically last 30-45 minutes.   Treatment protocols vary, but our standard depression treatment is 5 sessions per week (Monday-Friday) for 6 weeks, then 3 sessions in week 7, 2 sessions in week 8 and a single, final session in week 9.


What other conditions have be studied for the use of TMS?
While insurance currently is paying only for the treatment of Major Depressive Disorder, Severe (F32.2 or F33.2), BrainsWay Deep TMS has been studied for anxiety and other conditions.


What are the side effects of TMS?
The side effects of TMS typically are minimal and include possible scalp discomfort or headache during the first few treatments.  Rare side effects include seizure (less than 5 of 1000 patients), however having a history of seizure is not a contraindication to TMS therapy.  


How long does the benefit from TMS last?
Most patients whose depression improves with TMS are still doing well a year later. For patients whose depression returns, TMS is again likely to be effective.


What is the difference between Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT)?
Transcranial magnetic stimulation (TMS) is a highly effective outpatient therapy for treatment-resistant depression with rates of full remission in 50% of patients and significant improvement in 75% of patients who have completed 36 sessions.  It has minimal side effects.  You can drive yourself to your appointment and, after your treatment, you can drive back to work or other activities. 


Electroconvulsive Therapy (ECT) is a highly effective treatment for severe depression that is performed in the hospital under general anesthesia.  It typically involves 10 to 20 treatments and utilizes an electrical current to induce a generalized seizure in the brain.  ECT is more expensive than TMS.  Common side effects of ECT include temporary memory loss and confusion, and some patients have a degree of permanent memory loss. Patients cannot drive or return to work on the day of the procedure.


Who will manage my medications during treatment? Will I stay on my current psychiatric medication during treatment?
One of our psychiatrists will thoroughly evaluate you prior to starting TMS, and will manage your psychiatric medications during your TMS course.  Many patients are able to reduce their psychiatric medication during treatment.  Following completion of TMS, patients typically return to their referring provider for ongoing care.

Where will I stay if I live outside of Helena?
For patients outside of Helena who cannot travel to Helena daily for TMS treatment, we will work with them to arrange temporary housing such as Airbnb or a VRBO.

Christina Walker, TMS Coordinator

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation is an effective, non-medication treatment for severe, treatment-resistant depression.  It works by utilizing a high intensity magnetic field to stimulate (depolarize neurons) areas of the brain, such as the dorsolateral prefrontal cortex (DLPFC), which are under-active in people with severe depression.


​At Big Sky Psychiatry, we provide BrainsWay Deep TMS Therapy, which is highly effective in improving depression in people who have had inadequate response to other treatments.


For referrals or to learn if you are a candidate for Transcranial Magnetic Stimulation at Big Sky Psychiatry, please call 406-204-2151 (extension 1) to speak with Christina Walker.