What to Expect


BIDMC's Dr. Pascual-Leone speaking with a man

Initial Consultation

An initial consultation will be scheduled with one of our team psychiatrists and one neurologist to discuss whether TMS is an appropriate treatment for you. At that time, you and your doctors will review your symptoms, treatment history, and possible treatment options, as well as ensuring that there are no safety contraindications for TMS. From here, we will work with your other clinicians to develop a course of therapy that is individualized to meet your needs.

Treatment Sessions

TMS sessions can take anywhere from just a few minutes to about forty minutes depending on the protocol being used. It is generally recommended Monday through Friday for a period of several weeks. You will be awake during treatment and reclined in a comfortable chair. A coil resembling a figure eight will be held in place over your head during the treatment session. As the current passes through the coil, it creates a magnetic field that will induce a current in your brain. After the treatment, you can resume your normal everyday activities.

Side Effects

TMS is not for everyone and there can be side effects. The most common side effects include headaches and ringing in the ears (earplugs are always worn to prevent this). TMS side effects also include a small risk of seizure and convulsion. This is a very rare complication; the reported risk is less than 1 in 1000 for rTMS and even lower in physically healthy patients. Because of the risk of side effects, careful evaluation by capable clinicians is critical and at BIDMC we have the benefit of longstanding experience and expertise.

Treatment Stages

TMS therapy generally consists of an initial induction period followed by a taper or continuation phase involving less frequent sessions. Depending on your response, acute treatment (inductions) usually involves daily treatment (Monday to Friday) sessions over a four- to six-week period. After your initial acute treatment, taper sessions may be recommended. Doctors will discuss this with you during your follow-up evaluations and will determine whether you would likely benefit from additional treatments.

Cost & Coverage

Many insurance providers will cover the cost of treatment. We will work with you to try to obtain reimbursement from your carrier. Patients can choose to pay out-of-pocket for TMS therapy treatments if the procedure is not currently covered by their insurance. For more information and a list of our current rates, please contact us at tms@bidmc.harvard.edu.

Provided below is a list of all the insurance companies that have either fully or partially covered TMS therapy to date:

  • Aetna
  • Blue Cross Blue Shield
  • Cigna
  • Commercial Insurance – other
  • GIC/Commonwealth of MA
  • Harvard Pilgrim
  • MassHealth (MBHP)
  • Medicare
  • Neighborhood Health Plan
  • Network Health
  • Tufts
  • United Behavioral Health