How is TMS generally performed?
The Standard TMS Protocol, called 10 Hz rTMS, takes just under a half hour to deliver. Patients generally come in 5 days a week (Monday – Friday) for 6 weeks (30 total sessions) and then proceed to a 3 week taper phase.
Many patients are able to stop TMS after the taper phase and maintain response. Some patients may require more sessions to see benefit. When clinically needed we extend treatment out an additional 10-20 sessions before tapering.
For patients who need ongoing maintenance or booster sessions we provide these services. Maintenance is usually performed from once a week to once a month as clinically needed.
What other procedures are available at your office?
A new form of TMS, known as Theta Burst or “Express TMS”, takes under 15 minutes to deliver and has now been FDA approved for treatment. Because of the reduced time needed for delivery we offer this protocol at a reduced cost for those paying out of pocket.
We also offer bilateral treatment, which has been shown in many studies to enhance treatment response. In our practice, we have seen a rapid reduction in anxiety in about 67% of our patients with this modality (Littman, L. and Datto, S. The use of continuous theta burst stimulation for the treatment of anxiety: A case series. Brain Stimulation. 2018).
We also offer Accelerated Protocols where we deliver multiple sessions in a day to shorten the time to recovery, or for patients who can only come to the office two to three days a week.
Are there any contraindications to TMS?
The main contraindication is any metal in the brain, head, or neck such as metal clamps, metal stents, cochlear implants, or pacemakers. Dental fillings are not a contraindication. If you have any questions please call us at 215-858-0839.
Is This Covered by My Insurance?
All insurances require a prior authorization for TMS coverage. Insurance companies have stringent criteria for coverage. For those who meet criteria, we will work on prior authorization after the initial consultation with Dr. Littman.
We are in network for patients with AETNA STUDENT HEALTH or those who mental health is through COMPSYCH.
We are considered an out of network provider for all other insurance companies. We will give you a receipt that you can submit to your insurance company for any out of network benefits. These are highly variable so please call your insurance company if this is a concern prior to your first appointment.
How Much Does it Cost?
We offer competitive pricing for our patients who pay out of pocket. For patients where costs are an issue we recommend the Theta Burst Protocol, which we offer at half the cost of our Standard Protocol. For patients who have Aetna Student Health or Comcast’s Compsych insurance and meet insurance coverage criteria there are no copays for the sessions. Please call for more details.
What are your office hours for TMS?
Treatments at our office are generally offered during the following hours:
Monday and Friday: 1 pm to 3 pm.
Wednesday: 10 am to 3 pm.
Initial consultations may be scheduled outside of these timeframes.
Do I continue to see my other treatment providers while I am getting TMS?
Yes. Dr. Littman will consult with all of your treatment providers as necessary.
Where Do I Park?
Street parking is available at the office (on Walnut St from 10:00 am until 3:30 pm) or in the multiple garages near the office such as the Doubletree lot on Broad and Locust.
Is There Public Transportation to the Office?
You can take the green line to city hall and then walk three blocks to Walnut Street. From NJ you can take PATCO to 13th and Locust and walk three blocks from there.
What Should I Do in Case of an Emergency?
You should call 911 or go to your nearest emergency room. For urgent calls that are not an emergency you can call Suzanne Datto at 215-858-0839 or Dr. Littman’s work cell phone at 215-906-5981.