A. TMS therapy and Spravato (esketamine nasal spray) are covered by most major commercial insurance plans when medical criteria are met, including Aetna, Anthem, Cigna, Medicare, Tricare, and UnitedHealthcare. 

Our Patient Care Team handles insurance verification, prior authorization, and qualification on your behalf from start to finish. Patients who are out-of-network or who want accelerated TMS treatment may have access to third-party financing options.

A. TMS (Transcranial Magnetic Stimulation) and antidepressants work through completely different mechanisms. Antidepressants are medications that adjust neurotransmitter levels throughout the body and brain systemically. TMS delivers focused magnetic pulses directly to the specific brain regions involved in mood regulation, without systemic medication effects. 

TMS has no sedation, no weight changes, no systemic side effects, and no daily pills. It is FDA-cleared for treatment-resistant depression and OCD, and is typically used when medications have not worked or have caused intolerable side effects. 

BrainsWay’s SWIFT protocol can complete a full TMS course in just 6 days of acute treatment.

A. Standard TMS involves one 20-minute session per day, five days a week, over six weeks. Accelerated TMS using BrainsWay’s SWIFT protocol patients complete 5 (10-minute long) rapid TMS sessions per day for 6 days in the span of 2 weeks, followed by (2) - 10 minute sessions per day, 1 day a week for 4 consecutive weeks.

Both use the same BrainsWay H1 Deep TMS coil and are FDA-cleared for treatment-resistant depression. 

Accelerated TMS is ideal for patients who need faster results or have scheduling constraints that make daily six-week treatment impractical. 

Clinical data from the SWIFT protocol shows an 87.8% response rate and 78% remission rate (Hanlon et al., Brain Stimulation, 2026).

A. Spravato is FDA-approved and is administered under direct medical supervision in our clinic. You will self-administer the nasal spray under Dr. Roth’s or one of our clinician's oversight and remain in our clinic for a two-hour monitoring period following each dose. 

Most patients experience mild dissociative effects or dizziness that resolve before they leave. You cannot drive on the day of a Spravato session, so you will need a ride home. 

Spravato is approved as a monotherapy for treatment-resistant depression and as an add-on treatment with an oral antidepressant. It works through a different brain pathway than traditional antidepressants, providing rapid-acting relief for patients who have not responded to other treatments.

A. TMS is appropriate for adults and adolescents (15+) with treatment-resistant depression or OCD who have tried antidepressants without adequate response. Spravato is approved for adults with treatment-resistant depression or major depressive disorder with acute suicidal ideation or behavior.

Our clinician team will review your family member’s diagnosis, medication history, prior treatments, and medical profile to determine which approach is the best fit. 

Many patients at Bluegrass Advanced Mental Health use a combination of treatments tailored to their specific situation.

A. With insurance, most patients at Bluegrass Advanced Mental Health pay only their standard specialist copay or coinsurance for standard Deep TMS, since TMS is covered benefit under most commercial plans when medical criteria are met. Accelerated TMS using the BrainsWay SWIFT protocol is $7500 all inclusive, covering evaluation, all treatment sessions, follow-up visits, and touch-up sessions within 6 months. Financing is available. Our patient care team verifies your specific benefits before you commit to anything.