Magnetic Depression Therapy: A Reimbursable Option

How exciting!  Magnetic depression therapy now has its own CPT codes, indicating a show of support for a unique technology.  Like most people, I would be at a loss for what this means if I had not written on the technology in the past.  But, over 15 million Americans suffer from depression and less than 80% of these patients can control their symptoms with medication.

Magnetic depression therapy is the only FDA-approved treatment for depression that does not include drugs or shock therapy.  Based on transcranial magnetic stimulation (TMS), this therapy is a noninvasive process that uses electromagnetic energy to stimulate the neurons in the brain.  This neuron activity changes the functions in the treated areas of the brain.  Along with treating severe depression, it is also being studied for the treatment of stroke, Parkinson’s disease, epilepsy, and migraines.

For 2011, CMS has established two codes: CPT 90867 (Therapeutic repetitive transcranial magnetic stimulation treatment; planning) and 90868 (Therapeutic repetitive transcranial magnetic stimulation treatment; delivery and management per session).  For the hospital, this translates to APC 0216 ($186 per session).  Considering treatments consist of 20 to 30 sessions, a hospital should expect revenue ranging from $3,720 to $5,580.

The therapy is FDA approved for patients that are no longer responding to two or more drug therapies.  Clinical trials indicate that patients treated with TMS therapy experienced an average of 27% reduced depression symptoms, compared to an average of 9% fewer symptoms in patients not receiving TMS treatment.

Depression is a costly disease to treat.  Drug therapy alone costs $970 to $3,600 per year.  Still, for patients in the later stages of depression, drug therapy may no longer be effective.  TMS therapy gives patients another treatment option, and with a new assigned CPT code, more payors should see it as a viable option.  This will enable a new opportunity for hospital outpatient departments.

James Laskaris, EE, BME
James Laskaris, EE, BME, Clinical Analyst — Mr. James Laskaris is a senior emerging technology analyst at MD Buyline and has been with the company since 1994. With over 30 years of experience in the healthcare field, Mr. Laskaris is the primary analyst of high-end OR technology. He also covers issues related to the legislative and reimbursement effect on healthcare and authors a bimonthly “Issues that Matter” publication. Mr. Laskaris received his biomedical engineering degree from Southern Illinois University. His work has been published in hfm Magazine, Radiology Manager and Healthcare Purchasing News.