Traditional MedicareCoverageHigh impact
Transcranial Magnetic Stimulation
Medicare/CMS - LCD·Neurology, Psychiatry, PM&R (Physical Medicine & Rehab)·Local Coverage Determination
Effective date
Aug 9, 2026
We identified it
Jun 25, 2026
Summary
INCOMPLETE POLICY DOCUMENT: The provided policy information for Local Coverage Determination L33398 (Transcranial Magnetic Stimulation) contains only header metadata and no actual policy content, coverage criteria, billing codes, or clinical guidelines. The billing team cannot implement changes without access to the full policy text. Obtain the complete policy document from the CMS Medicare Coverage Database link provided before proceeding.
Action Required
BEFORE 2026-08-09: Billing team must obtain and review the complete policy text for LCD L33398 by accessing https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33398&ver=39. Contact NGS (contractor) directly if policy document is not accessible. Once full policy is obtained, identify: (1) specific CPT/HCPCS codes for TMS procedures, (2) coverage criteria and medical necessity requirements, (3) prior authorization requirements, (4) documentation requirements, and (5) any bundling or billing rule changes. Update billing software, encounter forms, and provider documentation templates accordingly. Do NOT submit claims for TMS services after 2026-08-09 without confirming compliance with finalized policy requirements. Failure to implement required changes may result in claim denials or payment recoupment.