{"id":6785,"date":"2026-07-17T14:32:06","date_gmt":"2026-07-17T14:32:06","guid":{"rendered":"https:\/\/medibillmd.com\/blog\/?p=6785"},"modified":"2026-07-17T14:32:07","modified_gmt":"2026-07-17T14:32:07","slug":"tms-cpt-codes","status":"publish","type":"post","link":"https:\/\/medibillmd.com\/blog\/tms-cpt-codes\/","title":{"rendered":"TMS CPT Codes &#038; Billing Guidelines (2026)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Did you know that the success rate for transcranial magnetic stimulation (TMS) therapy ranges from <a href=\"https:\/\/www.tmscentralflorida.com\/blog\/how-successful-is-tms-therapy\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">70 to 80%<\/a>?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">However, TMS providers often struggle with claims denials for these critical therapy sessions. This guide explores the common causes leading to denials.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What&#8217;s more? We will provide an overview of the primary TMS CPT codes and share the best practices to streamline your billing workflow.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So, continue reading!<\/p>\n\n\n\t\t\t\t<div class=\"wp-block-uagb-table-of-contents uagb-toc__align-left uagb-toc__columns-1 uagb-toc__collapse uagb-block-047439d5      \"\n\t\t\t\t\tdata-scroll= \"1\"\n\t\t\t\t\tdata-offset= \"30\"\n\t\t\t\t\tstyle=\"\"\n\t\t\t\t>\n\t\t\t\t<div class=\"uagb-toc__wrap\">\n\t\t\t\t\t\t<div class=\"uagb-toc__title\">\n\t\t\t\t\t\t\tTable Of Contents\t\t\t\t\t\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 384 512\"><path d=\"M192 384c-8.188 0-16.38-3.125-22.62-9.375l-160-160c-12.5-12.5-12.5-32.75 0-45.25s32.75-12.5 45.25 0L192 306.8l137.4-137.4c12.5-12.5 32.75-12.5 45.25 0s12.5 32.75 0 45.25l-160 160C208.4 380.9 200.2 384 192 384z\"><\/path><\/svg>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uagb-toc__list-wrap \">\n\t\t\t\t\t\t<ol class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#tms-cpt-codes\" class=\"uagb-toc-link__trigger\">TMS CPT Codes<\/a><li class=\"uagb-toc__list\"><a href=\"#common-reasons-for-tms-claim-denials\" class=\"uagb-toc-link__trigger\">Common Reasons for TMS Claim Denials<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#pre-authorization-errors\" class=\"uagb-toc-link__trigger\">Pre-Authorization Errors<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#session-tracking-sequencing-errors\" class=\"uagb-toc-link__trigger\">Session Tracking &amp; Sequencing Errors<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#lack-of-medical-necessity\" class=\"uagb-toc-link__trigger\">Lack of Medical Necessity<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#unapproved-same-day-em-billing\" class=\"uagb-toc-link__trigger\">Unapproved Same-Day E\/M Billing<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#exceeding-therapy-limits\" class=\"uagb-toc-link__trigger\">Exceeding Therapy Limits<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#coding-errors\" class=\"uagb-toc-link__trigger\">Coding Errors<\/a><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#best-practices-to-minimize-tms-claim-denials\" class=\"uagb-toc-link__trigger\">Best Practices to Minimize TMS Claim Denials<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#implement-a-pre-authorization-workflow\" class=\"uagb-toc-link__trigger\">Implement a Pre-Authorization Workflow<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#audit-physician-charts\" class=\"uagb-toc-link__trigger\">Audit Physician Charts<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#proactively-track-sequential-session\" class=\"uagb-toc-link__trigger\">Proactively Track Sequential Session<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#isolate-same-day-em-encounters\" class=\"uagb-toc-link__trigger\">Isolate Same Day E\/M Encounters<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#document-explicit-triggers-for-remapping\" class=\"uagb-toc-link__trigger\">Document Explicit Triggers for Remapping<\/a><\/li><\/ul><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#streamline-tms-billing-with-medibillmd\" class=\"uagb-toc-link__trigger\">Streamline TMS Billing with MediBillMD<\/a><\/ul><\/ul><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>TMS CPT Codes<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The table below offers an at-a-glance view of the three primary CPT codes for TMS therapy:<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th class=\"has-text-align-center\" data-align=\"center\"><strong>TMS Billing Codes<\/strong><\/th><th><strong>Description<\/strong><\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\">90867<\/td><td>It covers the initial therapeutic TMS session. That is, it includes the initial cortical mapping, motor threshold determination, and delivery.<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">90868<\/td><td>It covers the subsequent therapeutic TMS sessions. That is, it includes the ongoing delivery and management for each subsequent treatment session.<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">90869<\/td><td>It is used when a provider must recalculate a patient&#8217;s motor threshold during a subsequent TMS session. It includes both the redetermination of electrical pulse intensity and treatment delivery.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Common Reasons for TMS Claim Denials<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Discussed below are some of the common reasons behind claim denials for transcranial magnetic stimulation CPT codes:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Pre-Authorization Errors<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It is one of the major reasons why a claim with a TMS CPT code is denied. Let&#8217;s consider a few examples:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>You acquired payer approval to render the service, but performed the therapy outside the approved date range. The result? Claim denial because you missed the approved pre-authorization deadline.<\/li>\n\n\n\n<li>Missing the pre-authorization number on the claim form altogether can also trigger a denial.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Session Tracking &amp; Sequencing Errors<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Do you know that insurance carriers closely monitor the chronological progression of daily treatments? Errors include documenting duplicate session numbers, skipping chronological sequences, or entering incorrect service dates.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">All these documentation errors can trigger automated denials on your claims with TMS billing codes.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Lack of Medical Necessity<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Establishing medical necessity is the key requirement set by all insurance carriers. This means payers require extensive, structured evidence in the physician&#8217;s chart notes demonstrating the medical necessity of the rendered TMS therapy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In case you fail to document a clear history of treatment-resistant depression, it will lead to medical necessity denials.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Unapproved Same-Day E\/M Billing<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">What happens when you attempt to bill a standard evaluation and management (E\/M) office visit on the same day as a routine CPT code for TMS therapy?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You receive a denial unless your documentation contains a completely separate, significant medical issue with relevant modifiers.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Exceeding Therapy Limits<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Most insurance carriers have a strict lifetime or annual cap on the total number of acute TMS sessions. Typical limits set by most payers are 36 sessions over a 6-week course.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In case you exceed this baseline unit limit without an active, secondary clinical authorization, it causes denials.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Coding Errors<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">What happens when you submit a remapping CPT code for transcranial magnetic stimulation, i.e., without documenting the precise physical shift in a patient&#8217;s motor threshold? It triggers a denial.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Best Practices to Minimize TMS Claim Denials<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The following are some of the best practices to ensure a seamless revenue cycle against your billed TMS CPT codes:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Implement a Pre-Authorization Workflow<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Avoid scheduling the first mapping sessions until you have a valid and active prior authorization number.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You can achieve it by:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Cross-referencing the approved date range.<\/li>\n\n\n\n<li>Ensuring the total sessions are under the allowable frequency.<\/li>\n\n\n\n<li>Verifying if a third-party behavioral health vendor handles the network carve-out.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Audit Physician Charts<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Verify that the physician&#8217;s intake notes document at least 2 to 4 failed antidepressant trials from different drug classes. That is not all; your documentation should also include a history of minimal response to evidence-based psychotherapy.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Proactively Track Sequential Session<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Utilize an EMR\/EHR system that hard-codes sequential counts. This will help you prevent automated duplicate denials for TMS billing codes.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Isolate Same Day E\/M Encounters<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The best practice is to avoid billing regular E\/M office codes alongside routine daily CPT codes for TMS.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But what happens when a psychiatric evaluation is absolutely necessary for an unrelated crisis? Then you should document it comprehensively and append modifier 25 to prevent denials.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Document Explicit Triggers for Remapping<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">You should only bill a remapping session if the chart notes clearly substantiate a physiological reason for a threshold shift.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some of the factors that you must not neglect while documenting include the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Introduction of a new medication<\/li>\n\n\n\n<li>Significant weight fluctuations<\/li>\n\n\n\n<li>Specific side effects that necessitated a manual motor-threshold recalculation<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Streamline TMS Billing with MediBillMD<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">To summarize, there are three primary TMS CPT codes. These include&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;(initial therapeutic TMS session), 90868 (subsequent therapeutic TMS sessions), and 90869 (motor threshold recalculation during a subsequent TMS session).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In case you are having trouble collecting timely reimbursements for these therapy codes, consider acquiring <a href=\"https:\/\/medibillmd.com\/specialties\/tms-billing-services\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>TMS billing services<\/strong><\/a> from professionals like MediBillMD. We offer tailored specialty-specific solutions with a dedicated account manager and around-the-clock support. Besides, we have a track record of guaranteeing a 98% clean claim rate and a 96% collection ratio.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"padding-top:0;padding-bottom:0;font-size:30px\"><strong>FREQUENTLY ASKED QUESTIONS<\/strong><\/p>\n\n\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-55da6e02 uagb-faq-icon-row-reverse uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\"><script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"@id\":\"https:\\\/\\\/medibillmd.com\\\/blog\\\/tms-cpt-codes\\\/\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"<strong>Is TMS fully covered by Medicare?\\u00a0<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes, Medicare Part B covers TMS therapy for adults. However, it is deemed medically necessary for treating severe major depressive disorder (MDD). Besides, a patient must be prescribed this therapy by a psychiatrist and have a documented history of treatment-resistant depression to qualify for the coverage.\"}},{\"@type\":\"Question\",\"name\":\"<strong>What insurances pay for TMS?\\u00a0<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Insurance carriers typically reimburse physicians anywhere between $120 and $250 per TMS therapy session.\"}},{\"@type\":\"Question\",\"name\":\"<strong>What is the Medicare-approved amount for TMS?\\u00a0<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare Part B typically covers 80% of the Medicare-approved amount for TMS therapy sessions after the patient has met their deductibles. As of 2026, Medicare Part B monthly premiums are set at $202.90, and the annual deductible is $283.\\u00a0\"}}]}<\/script><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-f4902fd4 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Is TMS fully covered by Medicare?\u00a0<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes, Medicare Part B covers TMS therapy for adults. However, it is deemed medically necessary for treating severe major depressive disorder (MDD). Besides, a patient must be prescribed this therapy by a psychiatrist and have a documented history of treatment-resistant depression to qualify for the coverage.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-7a7092b6 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>What insurances pay for TMS?\u00a0<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Insurance carriers typically reimburse physicians anywhere between $120 and $250 per TMS therapy session.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-b992f47f \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>What is the Medicare-approved amount for TMS?\u00a0<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Medicare Part B typically covers 80% of the Medicare-approved amount for TMS therapy sessions after the patient has met their deductibles. As of 2026, Medicare Part B monthly premiums are set at $202.90, and the annual deductible is $283.\u00a0<\/p><\/div><\/div><\/div>\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Did you know that the success rate for transcranial magnetic stimulation (TMS) therapy ranges from 70 to 80%? 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