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TMS and Medicaid: What Arizona AHCCCS Members Need to Know

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Published in: Access to Care

Yes—You May Qualify for Covered Depression Treatment

If you’re an Arizona AHCCCS member living with treatment-resistant depression, you might feel like you’ve already tried everything: medication, therapy, and maybe even hospitalization. But there’s another option that’s often overlooked—Transcranial Magnetic Stimulation (TMS).

And the best part?
You may be eligible to receive TMS through your AHCCCS plan.

At Bella Vida TMS, we work directly with AHCCCS-contracted health plans to make sure patients across Phoenix, Glendale, Scottsdale, and Gilbert can access the care they need. Here’s what you need to know about TMS therapy and how it works with AHCCCS.

What Is TMS Therapy?

TMS (Transcranial Magnetic Stimulation) is an FDA-cleared, non-invasive treatment for major depressive disorder, especially when antidepressants haven’t worked.

It uses gentle magnetic pulses to stimulate the areas of the brain responsible for mood regulation. The treatment is:

  • Drug-free
  • Done in-office
  • Well-tolerated
  • Typically completed in 6 to 9 weeks

TMS is covered by most commercial insurance—and in many cases, Arizona Medicaid (AHCCCS) too.

Does AHCCCS Cover TMS Therapy?

✅ Yes—through contracted health plans.

While AHCCCS (Arizona’s Medicaid program) doesn’t administer TMS directly, it partners with Managed Care Organizations (MCOs) that often do.

TMS may be covered through plans like:

Each plan has its own requirements, but Bella Vida TMS can help determine your eligibility and handle the prior authorization process from start to finish.

What Are the Requirements to Qualify?

To get TMS approved under AHCCCS, you typically need to show that:

  • You’ve been diagnosed with major depressive disorder
  • You’ve tried at least two different antidepressant medications
  • You’ve tried talk therapy or counseling
  • You’re not currently experiencing seizure risk or other contraindications
  • You’re referred or evaluated by a psychiatric provider

Don’t worry—we help you gather all of this. Our clinical team will conduct a full psychiatric evaluation and submit all documentation required for insurance approval.

How Bella Vida TMS Helps AHCCCS Patients

We don’t just offer TMS—we walk you through the whole process:

  • We verify your AHCCCS plan benefits for free
  • We complete and submit all prior authorizations
  • We provide Letters of Medical Necessity when required
  • We offer continued support throughout your treatment

Whether you’re with Mercy Care, Banner, or another plan, our team has experience working with Arizona’s Medicaid system and advocating for your mental health needs.

What If TMS Isn’t Covered?

If your specific AHCCCS plan doesn’t cover TMS yet, you still have options:

  • We help you file an appeal to request an exception
  • We may explore Spravato®, another covered option for treatment-resistant depression
  • We offer low-cost cash-pay rates and CareCredit financing
  • We can work with your current providers to build a long-term plan

Our goal is always the same: helping you get the care you need, when you need it.

TMS and AHCCCS

If you’re an AHCCCS member and you’re still battling depression despite medication and therapy, TMS may be the breakthrough you’ve been waiting for.

At Bella Vida TMS, we believe that financial status should never block access to healing. That’s why we partner with Arizona’s Medicaid system to bring cutting-edge, compassionate care to those who need it most.

📚 References

  1. AHCCCS (Arizona Health Care Cost Containment System) – Health Plan Information and Member Handbook
    https://www.azahcccs.gov
  2. National Institute of Mental Health (NIMH) – Depression: Overview and Treatments
    https://www.nimh.nih.gov/health/topics/depression
  3. Centers for Medicare & Medicaid Services (CMS) – National Coverage Determination for TMS
    https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=374
  4. Mayo Clinic – Transcranial Magnetic Stimulation (TMS): What to Expect
    https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
  5. Spravato® Official Website – FDA-approved Esketamine Therapy for Depression
    https://www.spravato.com

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