Providence, R.I. – Transcranial Magnetic Stimulation (TMS), an FDA approved treatment for depression that Butler Hospital began offering in 2008, is now covered by Medicare. Thanks to the work of advocates like Dr. Linda Carpenter, Butler’s Chief of Mood Disorders and the Neuromodulation, patients in New England with Medicare coverage are able to receive this innovative, effective treatment for acute depression.

Butler was one of the first hospitals in the region to offer TMS therapy three years ago. At the time, Dr. Carpenter was excited for the hope this treatment could bring to patients unable to find symptom relief through medication. What Dr. Carpenter didn’t anticipate was that in addition to providing treatment and care for her patients using TMS, she’d also spend months advocating on their behalf, writing countless appeals letters to insurance companies who were reluctant to pay for the treatment, and representing the patients in legal and community hearings to make the case for coverage of the new treatment.

“The initial FDA approval of TMS therapy gave hope to many psychiatrists who saw patients whose symptoms were not relieved through traditional medications,” states Dr. Carpenter, adding that it wasn’t until she began treating patients with TMS that she realized how difficult an obstacle she and her patients would face trying to convincing insurers that this was the best and only line of treatment that could relieve their symptoms.

Treatment with TMS is reserved for patients whose depression does not improve with antidepressant medication therapy. Unlike more invasive options after medication, like vagus nerve stimulation (VNS) which requires surgery, and electroconvulsive therapy (ECT) which requires anesthesia, TMS uses a noninvasive device that beams magnetic pulses through the skull of an awake patient, to stimulate the brain and induce electrical activity in circuits throughout the brain involved in major depression. During TMS Therapy, patients sit in a chair that resembles something one might find at a dentist office. An MRI-strength magnet is positioned near the patient’s scalp on the left side, aimed at the prefrontal cortex. The treatment sessions each take about 30 minutes and are recommended five times a week for up to six weeks.

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“TMS is a game changer for the treatment of depression. And now that Medicare has approved coverage of TMS for the patients who need it, we’re hopeful that other insurers will follow,” said Dr. Carpenter. “Since it was approved by FDA in 2008, ongoing research has consistently shown the benefits of TMS for patients with depression. Medicare’s decision to cover the treatment really reflects how strong the science is, which will in turn help many clinicians and patients realize that TMS is safe and effective.”

Butler Hospital is the only private, nonprofit psychiatric and substance abuse hospital serving adults, adolescents and children in Rhode Island and southeastern New England. Founded in 1844, it was the first hospital in Rhode Island and has earned a reputation as the leading provider of innovative psychiatric treatments in the region. The flagship hospital for the Department of Psychiatry and Human Behavior at the Alpert Medical School of Brown University, Butler is recognized worldwide as a pioneer in conducting cutting-edge research.


  1. This article is seriously misleading in my opinion especially the following quotation:

    “And now that Medicare has approved coverage of TMS for the patients who need it, we’re hopeful that other insurers will follow,”

    I strongly feel Dr. Carpenter was probably misquoted and made no such statement. While maybe there have been instances of Medicare approving coverage on a case by case basis, upon additional investigation and several conversations, I’ve learned there is no formal CMS (Centers for Medicare/Medicaid Services) approval for this therapy option.

    Had there been such an approval I’m certain the sponsor of the therapy would be all over the media promoting its formal approval.

    I am an advocate for additional treatment options knowing that many of the conventional therapies have proven ineffective for this unique population of patients.


  2. Herb, not hard to determine the motive for your blatant lies given your user name vns therapy (vagal nerve stimulation therapy- the surgical implantation of a electronic stimulator, a now defunct treatment not longer covered by insurance companies or Medicare for depression)

    TMS DOES HAVE MEDICARE COVERAGE IN NEW ENGLAND, please click below to read the press release from the company that makes the policy decisions for Medicare in New England, and the company, NHIC’s own update to announce the coverage:

    You are an advocate of your treatment, which requires a surgical procedure, and has been proven inneffective for depression.
    You are either very ill-informed, malicious, or jealous. After posting your retraction, please do not speak for Medicare or their local coverage determinations, unless your intention is to mislead, which of course you seem very effective at when unchecked by the truth.

  3. Hi Severon,

    First, I say thank you for the informational links you’ve listed.

    Secondly, I live and learn every day and most often from those who would politely take the time to share with me. As for my motives and any other personal assessment you may have of me, you’re grossly off base.

    What is truly fascinating to me is the fact that there has been no national determination by CMS to the best of my knowledge as was the case with VNS Therapy for Depression. Those many years ago, being a total novice, I thought once the FDA approved a treatment that was it. Go know, I believe for the first time, a medical device treatment was FDA approved but CMS – National declined reimbursement and the rest is history along with a number of other issues.

    Now, I learn from you by way of citing those two links that it appears each and every state or district can make their own Medicare determination. Again, thank you. I was not aware of that fact.

    I am an advocate for patient education while encouraging hope and persistence. I also advocate for research into newer treatment options because the conventional therapies have proven ineffective for this seriously ill large population of patients. As a very, very long-time support person and health care advocate for my spouse I personally am happy to read about this decision as TMS would be an option I would consider before for ECT or VNS for a number of reasons.

    I do not endorse or promote the use of any treatments, products and/or companies contrary to any of your beliefs.

    Now I would like to see if in fact Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont actually follow through on this decision and if the private insurance carriers follow suit?

    Since you are familiar with the situation and you do have my email address I’d appreciate your taking time, if you don’t mind, to try to keep me updated as events unfold. I shall share this information with a number of others who do have interest in this and other alternative treatment options.

    Thanks again, your reply was most appreciated.