Estimates, not medical or insurance advice. Your plan and your doctor decide what you pay and what fits.
A full course of standard TMS usually costs $6,000 to $15,000 without insurance (2026 published clinic prices). With insurance, our model puts it at about $800 to $1,200 out of pocket if your deductible is met and your coinsurance is 20%, and up to about $6,050 with a high deductible. With Original Medicare in Utah, it's about $1,050 (2026 Noridian rates). Cognitive FX, a clinic in Provo, Utah, charges $9,900 for one week of fMRI-guided accelerated TMS, with the scan and therapy included.
Estimate your TMS cost
Your insurance cost for standard TMS next to our $9,900 one-week program. About 2 minutes. No email needed.
A full course of standard rTMS usually costs $6,000 to $15,000 without insurance, and accelerated fMRI-guided TMS at Cognitive FX is $9,900 for the week. Your clinic's price and your insurance plan decide your real cost.
Rarely (we don't bill insurance; HSA/FSA usually OK)
Cognitive FX, Oct 2026
Standard rTMS range from 2026 published price guides (TherapyExplained: $6,000 to $12,000; Exxceed Wellness: $6,000 to $15,000). For reference, Medicare in Utah allows about $4,022 for a 36-session course in 2026 (Noridian fee schedule).
SAINT® is a registered trademark of Stanford University, exclusively licensed to Magnus Medical. The SAINT Neuromodulation System received FDA 510(k) clearance in September 2022 for adults with major depressive disorder who haven't improved enough on antidepressants in their current episode. Cognitive FX is not affiliated with Stanford or Magnus and does not offer SAINT. Our accelerated, fMRI-guided schedule is an off-label use of an FDA-cleared TMS device.
In 2026, Medicare in Utah allows $108.93 for each rTMS treatment session and $209.27 for the first session, which includes mapping (Noridian fee schedule). At published cash prices of $6,000 to $15,000 for about 36 sessions, a session works out to roughly $165 to $420.
How much does accelerated TMS cost?
Accelerated TMS prices vary by clinic and protocol, and insurance rarely covers them. At Cognitive FX, accelerated fMRI-guided TMS is $9,900 all-in for an fMRI scan, 50 TMS sessions over 5 days and therapy during the week, and the One-D one-day intensive is $3,000.
How much does TMS cost with insurance?
With insurance, your out-of-pocket cost depends on your remaining deductible, coinsurance and out-of-pocket maximum. Using 2026 Utah Medicare rates as a base, our model puts it at about $800 to $1,200 with a met deductible and 20% coinsurance, and up to about $6,050 with a high deductible. For coverage rules, see does insurance cover TMS therapy?
What does Medicare pay for TMS?
Medicare covers TMS for treatment-resistant depression when its coverage rules are met. In Utah in 2026, Medicare allows about $4,022 for a 36-session course (Noridian); after the $283 Part B deductible and 20% coinsurance, you would pay about $1,050 without supplemental coverage.
How much does TMS cost without insurance?
A full course of standard TMS usually costs $6,000 to $15,000 without insurance (2026 published clinic prices). Accelerated fMRI-guided TMS at Cognitive FX is $9,900 for the full week, with the fMRI scan and therapy included.
Does insurance cover accelerated TMS?
Usually not. Most insurers cover standard daily TMS with prior authorization but rarely cover accelerated protocols, which is why Cognitive FX charges one all-in price instead of billing insurance.
How many antidepressants do I need to try before insurance covers TMS?
Most plans want you to have tried at least two antidepressants at a full dose, and some ask for four or for medications from different drug types. Many also want a trial of talk therapy and prior authorization from your doctor.
Can I use HSA or FSA for TMS?
You can usually pay for TMS with HSA or FSA funds, and Cognitive FX provides an itemized receipt. CareCredit financing is also available.
What affects the price of TMS?
The biggest factors are the number of sessions, whether targeting uses a brain scan, the clinic's location and type, and whether your insurance covers the clinic in network. Accelerated programs pack more sessions into fewer days, so their price covers a whole week of care. For help comparing clinics, see how to find and evaluate TMS clinics.
Is standard TMS or fMRI-guided accelerated TMS better?
In separate sham-controlled trials (not head-to-head), fMRI-guided accelerated TMS reported 57% remission right after treatment, compared with 27% to 32% for standard daily TMS added to medication. Accelerated TMS also finishes in 5 days instead of 6 to 9 weeks.
Standard TMS finds its target with a scalp measurement. In one study, that spot was about 3 cm, on average, from each person's own fMRI target (Cash 2021).
Does the fMRI target make a difference? A 2026 randomized, blinded trial tested exactly that. All 40 people with treatment-resistant depression got the same accelerated TMS (10 sessions a day for 5 days). The only difference was the target: half were treated at a spot mapped from their own fMRI scan, half at the standard scalp-measured spot. One month later, 80% of the fMRI-targeted group had responded (symptoms cut at least in half), compared with 60% of the scalp-targeted group, a large effect. That works out to about one extra person helped for every five treated with fMRI targeting (Taylor 2026, JAMA Psychiatry, as summarized by the Brain & Behavior Research Foundation).
This trial mapped each person's target with its own fMRI method and is not a study of Cognitive FX patients. Individual results vary.
Cognitive FX uses an FDA-cleared TMS device. The accelerated, fMRI-guided schedule is an off-label use of that device, which we explain at your consult.
After two antidepressants haven't worked, the next one brings remission for about 13% to 18% of people (STAR*D reanalysis; ESCAPE-TRD). In trials of people with treatment-resistant depression, standard TMS reached 27% to 32% and fMRI-guided accelerated TMS 57% right after treatment.
MedicationStandard TMSfMRI-guided accelerated TMS
1st SSRI28%
STAR*D, Trivedi 2006
2nd medication21%
STAR*D, Pigott 2023
3rd medication13%
STAR*D, Pigott 2023
4th medication10%
STAR*D, Pigott 2023
Standard TMS with medication27% to 32%
THREE-D, Lancet 2018
fMRI-guided accelerated TMS57% right after
Cole 2022; tick = 50% at one month, Kratter 2026
Published research, not Cognitive FX results. Different trials, not head-to-head. Medication courses up to 14 weeks; TMS courses 1 to 6 weeks.
Remission rates for antidepressants and TMS in published studies
Treatment
Remission
When measured
Study
First SSRI (citalopram)
28%
Up to 14 weeks
STAR*D, Trivedi 2006, n=2,876
Second medication
21.3%
End of step
STAR*D reanalysis, Pigott 2023
Third medication
13.2%
End of step
STAR*D reanalysis, Pigott 2023, n=325
Fourth medication
10.4%
End of step
STAR*D reanalysis, Pigott 2023
Next medication after 2+ failures
17.6%
Week 8
ESCAPE-TRD, Reif 2023, NEJM, n=340
Standard daily TMS with medication
27% to 32%
4 to 6 weeks
THREE-D, Blumberger 2018, Lancet, n=414
Standard TMS, 42 US clinics
28.7%
End of course
Carpenter 2012, n=307
fMRI-guided accelerated TMS
57% (sham 0%)
Right after treatment
Cole 2022, Am J Psychiatry
fMRI-guided accelerated TMS
50% (sham 21%)
One month after
Kratter 2026, World Psychiatry, n=48
A smaller open-label pilot reported 90.5% remission immediately after treatment (19 of 21 people; Cole 2020).
Cross-trial comparison, not a head-to-head trial. Remission definitions differ: MADRS 10 or lower (ESCAPE-TRD, fMRI-guided trials); HRSD/HAMD-based (STAR*D, THREE-D); PHQ-9 (Carpenter). fMRI-guided accelerated results reflect individualized targeting plus a high-dose protocol (50 sessions over 5 days) and are not the results of any specific clinic, including Cognitive FX. Compare with other options in ketamine vs TMS.
Why do some sites say 79% or 90%?
The 79% and 90% figures are real, but they measure different things than the 57% we use: 90% comes from a 21-person pilot with no sham group, and 79% counts anyone who reached remission at any check-in during the month after treatment. Here is what each number means.
What the 90%, 79%, 57% and 50% remission figures measure
Number
What it measures
Study design
Source
90%
In remission right after the 5-day course. One month later, 60%.
Pilot, 21 people, no sham group
Cole 2020, Am J Psychiatry
79%
Reached remission at any check-in during the 4 weeks after treatment (11 of 14, vs 2 of 15 on sham). Not the share in remission at one point in time.
Sham-controlled trial
Cole 2022
57%
In remission right after the treatment week, vs 0% on sham. This is the number we use, because it comes from a sham-controlled trial at a single point in time.
Sham-controlled trial
Cole 2022
50%
In remission one month after treatment, vs 21% on sham.
Sham-controlled trial, 48 people
Kratter 2026, World Psychiatry
These studies tested SAINT®, a registered trademark of Stanford University, exclusively licensed to Magnus Medical. Cognitive FX is not affiliated with Stanford or Magnus and does not offer SAINT. Our program uses its own fMRI-guided accelerated protocol. For SAINT pricing, see SAINT treatment cost.
How long do results last, and what do boosters cost?
After one 5-day course, remission lasted about 11 weeks on average in an open-label study, and a repeat course worked about as well as the first. At Cognitive FX, you get scheduled follow-ups after your week, plus remote visits in states where our doctors are licensed, and past patients get discounted pricing on booster sessions.
One 5-day course: in an open-label study of 46 people who had no boosters, 70% were in remission the week after treatment, and about half of them were still in remission 12 weeks later (Geoly 2025, Brain Stimulation).
A second course works too: people who had a repeat course responded about as well as the first time (Geoly 2024, American Journal of Psychiatry).
Boosters when symptoms return: in a small pilot where people got a booster day when early signs of relapse showed up, participants were in remission for about 86% of the following year (Stimpson 2025, company-run pilot without a control group).
Standard TMS needs follow-up as well: across 42 US clinics, 62.5% of people kept their response for 12 months, and about a third needed extra sessions along the way (Dunner 2014, Journal of Clinical Psychiatry). More in how long do TMS results last?
Is TMS treatment worth the cost?
For people whose depression hasn't improved after two or more antidepressants, TMS offers better odds than another medication: 27% to 32% remission with standard TMS (THREE-D, Lancet 2018) vs about 13% to 18% on the next medication (STAR*D reanalysis, Pigott 2023; ESCAPE-TRD, NEJM 2023). Whether it's worth it for you depends on what your plan covers and how fast you need to finish.
For insurance, the estimator assumes a standard course of 36 sessions: one initial session (CPT 90867) plus 35 treatment sessions (CPT 90868). It ignores re-mapping (CPT 90869) for simplicity. Medicare does not set one national price for these codes; each regional contractor does. We use the 2026 Utah rates from Noridian, the Medicare contractor for Utah: $209.27 for the initial session and $108.93 per treatment session, about $4,022 for the course (Noridian 2026 fee schedule). Private plans often pay more than Medicare, so we model them at 1x to 1.5x that amount ($4,022 to $6,033).
Your cost = the part of the allowed amount that falls within your remaining deductible, plus your coinsurance on the rest, up to what is left of your out-of-pocket maximum. Deductible ranges use midpoints: under $1,000 = $500, $1,000 to $3,000 = $2,000, $3,000 to $6,000 = $4,500, over $6,000 = $7,000. Out-of-pocket ranges: under $2,000 = $1,000, $2,000 to $5,000 = $3,500; "over $5,000" never limits a TMS course. If you choose "not sure", it uses a $1,500 remaining deductible, 20% coinsurance and no out-of-pocket cap, so the estimate isn't too low.
High-deductible plans: in 2026, a plan that qualifies for an HSA has a deductible of at least $1,700 for one person and an out-of-pocket maximum of no more than $8,500. Most other plans can go up to $10,600 for one person (IRS Rev. Proc. 2025-19; CMS 2026 Notice of Benefit and Payment Parameters). When your remaining deductible is larger than the cost of the course, you pay the plan's full negotiated rate. Once you reach your out-of-pocket maximum, covered care is usually paid in full for the rest of the plan year. Both usually reset on January 1.
For Original Medicare, it uses the 2026 Part B deductible ($283) and 20% coinsurance, with no cap. Medicaid and VA coverage vary, so the tool doesn't estimate a dollar amount for them. Travel uses your airfare (or $150 to $500) plus hotel nights at about $110. Dollar amounts are rounded to the nearest $50.
Sources
Noridian JF Part B. 2026 Medicare Physician C-Status Fee Schedule, Utah Area 09 (CPT 90867, 90868). Effective January 1, 2026.
TherapyExplained. TMS Therapy Cost: 2026 Pricing and Insurance Guide. Exxceed Wellness. How Much Is TMS Therapy? 2026.
IRS Rev. Proc. 2025-19 (2026 HSA and HDHP limits). CMS 2026 Notice of Benefit and Payment Parameters (out-of-pocket maximum).
Trivedi MH et al. STAR*D, Am J Psychiatry 2006. Pigott HE et al. STAR*D reanalysis, BMJ Open 2023.
Reif A et al. ESCAPE-TRD, N Engl J Med 2023.
Blumberger DM et al. THREE-D, Lancet 2018. Carpenter LL et al. Depress Anxiety 2012. George MS et al. OPT-TMS, Arch Gen Psychiatry 2010.
Cole EJ et al. Am J Psychiatry 2020 and 2022. Kratter IH et al. World Psychiatry 2026.
Taylor JJ et al. JAMA Psychiatry 2026, summarized by the Brain & Behavior Research Foundation. Cash RFH et al. 2021.
Geoly AD et al. Brain Stimulation 2025; Am J Psychiatry 2024. Stimpson KH et al. 2025. Dunner DL et al. J Clin Psychiatry 2014.
Dr. Lynn Gaufin graduated from the University of Utah and then attended medical school at Cornell University in New York City. After medical school he join the Army and was a surgeon in the military before finishing his Neurological Residency at University of California Los Angeles. Dr. Gaufin specializes in cervical and lumbar spine surgery, brain tumors, brain hemorrhages, and treatment of traumatic brain injuries. Dr. Gaufin is one of the emergency trauma neurosurgeons on call at Utah Valley Hospital. Before he began his practice in Utah he saw a significant amount of traumatic brain injuries during his career in the Army and his residency in Los Angeles. As a surgeon who treats individuals who suffer from mild to severe traumatic brain injuries he recognized a problem in the post operative rehabilitation. Individuals who suffered severe trauma would be admitted into speciality facilities where they would receive months of care. But patients who had a more mild trauma would be released and would largely be on their own when it came to restoring their cognitive function. That problem is what lead Dr. Gaufin to team up with Dr. Fong and Dr. Allen in the creation of Cognitive FX. Cognitive FX was able to take the research that Dr. Fong and Dr. Allen started in their Phd programs and bring it into the clinical environment.
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