California Expands Mental Health Access: TMS Coverage Added to Medi-Cal for Millions

California Medicaid (Medi-Cal) has added coverage for Transcranial Magnetic Stimulation (TMS) treatment for adults and adolescents aged 15 and older with major depressive disorder, potentially benefiting 14.8 million covered lives.

Key points:

  • The TMS policy update will go into effect on August 1, 2024, providing no-cost or low-cost access to this treatment for eligible Californians.
  • Neuronetics’ NeuroStar TMS is the first and only TMS treatment with FDA clearance for adolescents aged 15-21.
  • This policy change follows recent TMS coverage updates from other major insurers, indicating a growing trend in expanding access to non-drug mental health treatments.

Market estimate: The global transcranial magnetic stimulation market size was valued at $1.04 billion in 2022 and is expected to expand at a compound annual growth rate (CAGR) of 8.9% from 2023 to 2030, according to Grand View Research.

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Landmark Decision for Mental Health Treatment

In a significant move to address the growing mental health crisis, California Medicaid (Medi-Cal) has announced the addition of Transcranial Magnetic Stimulation (TMS) coverage for adults and adolescents aged 15 and older with major depressive disorder (MDD). This decision, effective August 1, 2024, will potentially impact 14.8 million covered lives in California.

Expanding Access to Innovative Treatment

The new policy marks the first time Medi-Cal has included TMS coverage, aligning with recent FDA clearance of Neuronetics‘ (NASDAQ:STIM) NeuroStar TMS as a first-line add-on treatment for adolescents aged 15-21. This expansion of coverage is particularly crucial given the estimated 4.3 million U.S. adolescents aged 15-21 affected by MDD.

Keith J. Sullivan, President and CEO of Neuronetics, Inc., emphasized the importance of this development: “At a time when mental health services are more essential than ever, expanded access to NeuroStar TMS through Medi-Cal is a pivotal step in addressing the growing need for care among both adults and adolescents.”

Growing Trend in Mental Health Coverage

This policy change is not isolated. Recent updates from other major insurers, including BlueCross BlueShield of Michigan, Cambia Health, and Humana, indicate a growing trend in expanding access to non-drug mental health treatments. As the only TMS company with FDA clearance for adolescent treatment, Neuronetics is at the forefront of this shift in mental health care.

Market Impact and Future Outlook

The global TMS market is projected to grow significantly. With a value of $1.04 billion in 2022 and an expected CAGR of 8.9% from 2023 to 2030, the inclusion of TMS in Medi-Cal coverage could substantially contribute to this growth while improving mental health outcomes for millions of Californians.

Source: Globenewswire

Image Source: Neuronetics

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