Planning once, treatment daily
CPT 90867 covers initial planning with motor threshold and is expected once per episode, not within six weeks of a prior one. Daily sessions use 90868, and 90869 covers motor threshold redetermination.
A TMS course depends on its first claim
Transcranial magnetic stimulation is billed as a course: one planning session, then many daily treatments that payers check against the original approval. Taiga works with mental health practices, drafting codes from treatment notes for clinician approval and working every denial through appeal.
Book a demoHow TMS claims are built
A single course can produce dozens of claim lines. Small errors repeat across all of them.
Diagnosis and history
Medicare covers TMS for severe major depressive disorder, and contractor articles list the qualifying diagnosis codes. The record has to show prior treatment history and a face-to-face assessment by the attending physician.
Ordering provider on every claim
One Medicare contractor's billing article requires the ordering provider's name and NPI on TMS claims. Missing it is an easy rejection to avoid.
Who runs which part of a TMS course
Treatment decisions stay clinical. The claim trail can move to Taiga.
Practice responsibilities
Candidate evaluation, treatment history, the treatment plan, daily session notes, and approval of codes before submission.
Taiga responsibilities
Eligibility checks, claim scrubbing and submission for each session, patient statements, and work on every denial and appeal.
Shared decisions
Agree on who requests and tracks course approvals, who watches session counts against them, and how retreatment requests are handled.
Before a TMS fit call
Bring a de-identified course from evaluation to final session. Keep protected details out of the booking form.
Which payers approve courses?
List the plans you see and how each approves an initial course and any retreatment.
Who delivers sessions?
Note the physicians, nurse practitioners, and technicians involved, and who supervises daily treatment.
How are sessions tracked?
Explain how you count delivered sessions against the approved number and where that record lives.
Who this fits
Independent psychiatry and TMS practices that run steady courses and want each session claim followed to payment. Taiga works alongside your current EHR.
Scope note
Coverage criteria for TMS differ between Medicare contractors and commercial plans. This page explains claim structure and does not decide whether a patient qualifies.
Questions about TMS billing
Does Taiga handle TMS claims?
TMS falls within the mental health work Taiga supports. Bring a sample course and your payer list so the team can confirm how it would run.
How often can 90867 be billed?
Medicare contractor guidance expects 90867 once per patient for a treatment episode and not more than once within six weeks. It should not be reported with 90868 or 90869.
Does Medicare cover TMS?
CMS lists transcranial magnetic stimulation for severe major depressive disorder among covered mental health services. Local coverage articles set the specific criteria and diagnosis codes.
What documentation do TMS reviewers look for?
Contractor guidance asks for a face-to-face assessment by the attending physician, review of contraindications before treatment, and records that support the diagnosis code billed.
Walk Taiga through a TMS course
Share how a course runs at your practice and which payers you bill. Taiga will tell you how it would handle the claims.
System guides show possible billing handoffs, not proven specialty compatibility.