CommercialCoverageMedium impact
07.03.22i, Therapeutic Transcranial Magnetic Stimulation (TMS)
Independence Blue Cross·Psychiatry, Neurology·Medical Policy
Effective date
Oct 19, 2026
We identified it
Oct 20, 2026
Summary
Independence Blue Cross updated its Therapeutic Transcranial Magnetic Stimulation (TMS) policy effective 10/19/2026 to clarify that standard TMS treatment duration, tapering schedules, and multiple daily TMS sessions are covered only under the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) protocol. The policy also refined SAINT/iTBS criteria for covered treatment days and target development requirements, and clarified that target development services are included in initial SAINT treatment.
Action Required
Effective 10/19/2026: Billing and clinical teams should review coverage criteria for TMS claims to ensure that standard TMS treatment duration, tapering schedules, and multiple daily sessions are only billed and approved under the SAINT protocol. Verify that target development services (CPT 0889T) are included in initial SAINT treatment and do not incur separate denials. Update clinical documentation templates to clearly distinguish SAINT protocol treatment from standard TMS to support medical necessity and prior authorization submissions. Confirm that claims submitted under standard TMS modalities (CPT 90867, 90868, 90869) without SAINT protocol documentation will be subject to denial under the revised policy. Contact Independence Blue Cross for specific prior authorization templates reflecting the updated SAINT/iTBS criteria.