If you’re researching Transcranial Magnetic Stimulation (TMS) for depression or another mental health condition, cost is usually one of the first practical questions that comes up.
The TMS treatment cost in Australia can vary depending on your eligibility for Medicare, the condition being treated, the number of sessions recommended, and the clinic providing treatment. Understanding how Medicare funding works and what fees may apply can help you make an informed decision before starting treatment.
This guide explains Medicare-funded TMS, private treatment costs, and funding options such as DVA and WorkCover. It also outlines the costs you may need to consider when accessing TMS treatment through a private clinic.
What Is TMS and Why Does Treatment Cost Vary So Much?
TMS, including repetitive transcranial magnetic stimulation (rTMS), is a non-invasive treatment that uses magnetic pulses to stimulate specific areas of the brain involved in mood regulation. For depression, treatment commonly targets the left prefrontal cortex.
TMS is most commonly used for major depressive disorder that has not responded adequately to previous treatment. Some clinics may also offer TMS for conditions such as anxiety, OCD, PTSD, or chronic pain. However, Medicare-funded rTMS has specific eligibility requirements and currently applies to eligible patients with major depressive disorder.
The cost of TMS treatment can therefore vary depending on whether you qualify for Medicare funding, the condition being treated, the number of sessions recommended, and the fee structure of the clinic you choose.
Medicare Coverage for TMS: The Basics
rTMS for major depressive disorder was added to the Medicare Benefits Schedule (MBS) in November 2021. Medicare funding is subject to specific clinical and eligibility requirements.
To qualify for a Medicare rebate for rTMS, patients generally need to meet several requirements, including:
- Be aged 18 years or older
- Have a diagnosis of a major depressive episode
- Have experienced an inadequate response to appropriate antidepressant treatment, including trials involving at least two different classes of antidepressants
- Have had the adequacy and adherence of previous antidepressant treatment assessed
- Have received treatment at an appropriate therapeutic dose and duration, where clinically appropriate
- Have received psychological therapy where clinically appropriate
- Be assessed and prescribed for rTMS by an appropriately trained psychiatrist
- Meet the other clinical requirements specified under the relevant MBS items
These requirements are specific, so meeting one or two criteria does not automatically mean that Medicare will cover TMS treatment. A psychiatrist will need to assess your individual circumstances and determine whether you meet the applicable MBS requirements.
For eligible patients, Medicare can subsidise an initial course of up to 35 rTMS treatment sessions. If a patient responds to treatment and later experiences a relapse, a further course of up to 15 sessions may be eligible for a Medicare rebate, subject to the relevant requirements.
A maximum of 50 Medicare-rebated rTMS treatment services applies over a patient’s lifetime under the current MBS arrangements.
It’s important to understand that Medicare eligibility does not necessarily mean every part of the treatment process will be bulk-billed. Clinics set their own fees, so patients should confirm any consultation or other out-of-pocket costs before commencing treatment.
What Medicare Doesn’t Cover
Medicare-funded rTMS currently applies to eligible patients with major depressive disorder who meet the relevant MBS criteria.
If you’re seeking TMS for conditions such as anxiety, OCD, PTSD, or chronic pain, treatment is generally not covered by Medicare under the current rTMS MBS items.
Depending on your circumstances, other funding arrangements may be available, including DVA or WorkCover.
If you’re considering TMS for a condition other than depression, ask your treating clinic whether the treatment is Medicare-rebatable and what costs may apply before starting.
What You’ll Actually Pay: Understanding TMS Costs
There isn’t one standard price for TMS treatment across Australia. Private clinics can have different fee structures, and the amount a patient pays depends on factors such as Medicare eligibility, the provider’s fees, the recommended treatment course, and whether another funding arrangement applies.
When comparing TMS providers, it’s important not to look only at the published per-session price. Ask about the total cost of the recommended treatment course, including the initial psychiatrist consultation, treatment planning or mapping, individual treatment sessions, follow-up appointments, and any applicable fees.
Medicare-Eligible Patients
For patients who meet the relevant Medicare Benefits Schedule (MBS) criteria, rTMS treatment for major depressive disorder may be eligible for a Medicare rebate. Depending on the provider’s billing arrangements, this can mean little or no out-of-pocket cost for the treatment sessions.
Medicare may cover an initial course of up to 35 rTMS treatment sessions, subject to eligibility and the applicable MBS requirements. A further course of up to 15 sessions may also be available for eligible patients who respond to treatment but later experience a relapse.
It’s important to note that Medicare coverage does not necessarily mean every part of the treatment pathway is free. Psychiatrist consultations, assessments, mapping, treatment planning or other services may have separate fees, depending on the provider and billing arrangements.
Before starting treatment, ask your provider for a clear breakdown of the Medicare rebate, consultation fees, treatment costs and expected out-of-pocket expenses, so you understand the total cost of your treatment.
Private, Non-Medicare-Eligible Patients
If you don’t meet the Medicare eligibility requirements, or you’re seeking TMS for a condition that isn’t covered by the current MBS indication, treatment may need to be privately funded.
Private TMS fees vary between providers. The total cost can depend on the number of sessions recommended, the treatment protocol, the provider’s fees, and whether psychiatric assessments or follow-up appointments are charged separately.
Before starting a self-funded course, ask the clinic for an itemised quote that clearly explains:
- The initial psychiatrist consultation fee
- Any treatment planning or mapping fees
- Per-session TMS treatment cost in Australia
- The expected number of sessions
- Follow-up psychiatrist appointments
- Any additional fees
- The estimated total cost of the recommended treatment course
This gives you a clearer picture of the overall financial commitment than comparing providers based only on their advertised per-session price.
If you’re considering private TMS treatment through TMS HUBB, the clinic’s team can explain the applicable fees and treatment pathway based on your individual circumstances.
DVA and WorkCover
Veterans may be able to access TMS through the Department of Veterans’ Affairs (DVA), depending on their circumstances, eligibility and the clinical requirements that apply to their treatment.
TMS may also be funded through WorkCover or another workers’ compensation arrangement where the treatment relates to an accepted claim and the relevant insurer or authority has approved it.
These arrangements can vary depending on the individual’s circumstances and the relevant scheme. If you think you may qualify, speak with your treating psychiatrist, GP, case manager, or the relevant funding authority before commencing treatment.
Questions Worth Asking Before You Start TMS
Because TMS pricing and funding arrangements can differ between patients and providers, it’s worth asking the following questions before beginning treatment:
- Do I meet the current Medicare eligibility criteria for depression-related rTMS?
- Has my eligibility been assessed by an appropriately trained psychiatrist?
- Is the TMS treatment course bulk-billed, or is there a gap fee?
- Is there a separate fee for the initial psychiatrist consultation?
- Are mapping, treatment planning and follow-up appointments included?
- If I’m not Medicare-eligible, what is the estimated total cost of my recommended treatment course?
- Could DVA, WorkCover, or another funding arrangement apply to me?
- What costs could apply if further treatment is recommended in the future?
Getting clear answers to these questions before starting treatment can help you understand your options and avoid unexpected costs.
Considering TMS? What You’ll Pay at TMS HUBB
At TMS HUBB, eligible Medicare patients can access an initial course of up to 35 rTMS sessions with no out-of-pocket cost for the treatment sessions. Our current fee structure for TMS treatment cost in Australia is designed to make the Medicare-funded TMS pathway as straightforward and transparent as possible.
For the initial psychiatrist consultation, our current out-of-pocket fee is $220, after the applicable Medicare rebate. This applies to both Psychiatrist Consultation Item 291 and 296.
For eligible patients, TMS mapping, up to 35 acute rTMS sessions, up to 15 extended/maintenance rTMS sessions, and follow-up review by our TMS psychiatrist have no out-of-pocket cost, subject to the applicable Medicare requirements.
If you’re considering TMS for depression and want to understand whether you may be eligible for Medicare-funded treatment, our team at TMS HUBB can help you understand the next steps.
Speak with our team to discuss your eligibility, treatment options and expected costs.
Frequently Asked Questions About TMS Cost
Q1. Is TMS covered by Medicare in Australia?
Ans. Yes. Medicare can provide rebates for rTMS for eligible patients with major depressive disorder who meet the relevant Medicare Benefits Schedule (MBS) criteria. Eligibility depends on factors including diagnosis, previous treatment, clinical assessment and other requirements. Your psychiatrist can determine whether you qualify.
Q2. How many TMS sessions does Medicare cover?
Ans. Eligible patients may receive Medicare-funded treatment for an initial course of up to 35 rTMS sessions. If treatment is successful but depression later relapses, a further course of up to 15 sessions may be available, subject to the relevant requirements and lifetime limits.
Q3. How much does TMS cost at TMS HUBB?
Ans. For eligible Medicare patients, TMS HUBB currently lists no out-of-pocket cost for the TMS treatment sessions. The clinic currently lists a $220 out-of-pocket fee for the initial psychiatrist consultation. Your eligibility and applicable fees should be confirmed with TMS HUBB before treatment begins.
Q4. Can I get TMS if I don’t qualify for Medicare?
Ans. You may still be able to receive TMS as a privately funded treatment if you don’t meet the Medicare eligibility criteria or are seeking treatment for a condition outside the current Medicare-funded indication. The cost will depend on the treatment plan and the provider. Ask the clinic for an itemised quote before starting.
Q5. Can DVA or WorkCover cover TMS treatment?
Ans. TMS may be funded through DVA or WorkCover in some circumstances, depending on your eligibility, clinical requirements and the relevant funding arrangements. Prior approval may be required. If you think you may qualify, discuss your circumstances with your treating psychiatrist, GP, case manager or relevant funding authority.