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CPT 90867: Initial Transcranial Magnetic Stimulation Treatment

CPT code 90867 denotes the initial transcranial magnetic stimulation (TMS) treatment session that encompasses cortical mapping, motor threshold determination, delivery of stimulation, and session management. TMS is an FDA-cleared, noninvasive neuromodulation therapy used to treat major depressive disorder when patients have not responded to prior therapies. Nationally, use of TMS has grown as clinical guidelines and payer coverage policies evolve, making accurate coding for the initial setup and delivery important for clinical documentation and claims processing.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of where CPT code 90867 is applied clinically, typical sites of service, and common billing considerations. The publication also highlights benchmark utilization patterns, reimbursement and coverage policy updates from major payers, and clinical context that clarifies when the initial TMS procedure is reported separately from subsequent treatment sessions. Data not available in the input for some specifics will be noted accordingly.

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Billing Code Overview

CPT code 90867 describes a transcranial magnetic stimulation (TMS) initial treatment that includes cortical mapping, motor threshold determination, treatment delivery, and session management. This procedure uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.

Service type: Procedural neurostimulation for major depressive disorder (initial TMS setup and delivery)

Typical site of service: Outpatient specialty clinic or hospital outpatient department where TMS equipment and trained staff are available

Data not available in the input.

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CPT 90867: Initial Transcranial Magnetic Stimulation Treatment

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Billing Code Overview

Service type: Procedural neurostimulation for major depressive disorder (initial TMS setup and delivery)

Typical site of service: Outpatient specialty clinic or hospital outpatient department where TMS equipment and trained staff are available

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 38-year-old patient with treatment-resistant major depressive disorder (unipolar), who has failed adequate trials of two antidepressant medications and psychotherapy, is referred for transcranial magnetic stimulation (TMS). The clinical workflow begins with an initial outpatient consultation by a psychiatrist or neuromodulation specialist to confirm indications, obtain informed consent, and review contraindications (e.g., implanted metallic devices in the head). On the same visit or a scheduled planning visit, cortical mapping and motor threshold determination are performed to identify the stimulation target and appropriate intensity. The initial TMS session includes setup, coil positioning, delivery of stimulation parameters (per protocol), and device/patient monitoring. Typical sessions occur in an ambulatory specialty clinic or hospital outpatient department with the patient conscious and monitored for tolerability. Documentation includes indication, mapping results (motor threshold), stimulation parameters, total pulses delivered, device used, adverse events, and care coordination notes for follow-up treatment sessions.

Coding Specifications

Modifier	Description	When to Use
`00`	Default — No modifier	Used when no special circumstances apply to the service
`22`	Increased procedural services	Use when the service required substantially greater work than typically required (rare for standard TMS delivery)
`23`	Unusual anesthesia	Use if unusual anesthesia unrelated to the procedure is provided for TMS (e.g., for severe agitation)
`52`	Reduced services	Use when TMS session is partially reduced (e.g., early termination with effective dose not delivered)
`53`	Discontinued procedure	Use when TMS session is started but discontinued due to patient intolerance or adverse event
`59`	Distinct procedural service	Use when TMS is separate and distinct from another service performed same day that is not usually reported together
`62`	Two surgeons	Rarely used; applies if two providers of different specialties shared responsibility for the procedure
`78`	Return to the operating/procedure room for a related procedure during the postoperative period	Use if patient requires an unplanned repeat procedure related to an intra-procedural complication (rare for TMS)
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use if an element of the TMS visit is delivered live via telemedicine as allowed by payer policy (limited applicability)
`QX`	Modifier to identify services performed by a qualified non-physician under supervision (when required)	Use when a qualified non-physician clinician performs the TMS procedure under required supervision agreements
`QY`	Certified registered nurse anesthetist service reporting (when applicable)	Use only if anesthesia services by a CRNA are separately reportable with the session
`TC`	Technical component	Use if billing separates technical component (equipment, device) from professional component; applies when facility or vendor bills separately
`26`	Professional component	Use when reporting only the physician professional component of the service (paired with `TC` when split)
`QK`	Medical direction by a physician for two or more qualified individuals	Use when physician directs multiple non-physician operators performing TMS under a medical direction model

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry & Neurology	Psychiatrists commonly evaluate and manage TMS candidates and oversee treatment
2084P0803X	Neuromodulation Specialist	Providers with neuromodulation focus perform mapping and device management
207Q00000X	Physical Medicine & Rehabilitation	Some physiatrists may perform or oversee TMS programs in outpatient settings
363LP0800X	Mental Health Therapist	Behavioral health professionals coordinate psychotherapy alongside TMS treatment
208000000X	Psychiatry	General psychiatric specialty involved in diagnosis, treatment planning, and follow-up

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F32.1`	Major depressive disorder, single episode, moderate	Common indication for TMS when antidepressant trials have been inadequate
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression is a frequent primary diagnosis for TMS treatment
`F32.2`	Major depressive disorder, single episode, severe without psychotic features	Severe depressive episodes are treated with TMS when other therapies are insufficient or not tolerated
`F33.2`	Major depressive disorder, recurrent severe without psychotic features	Indicates severity and recurrence supporting consideration of TMS
`F33.42`	Major depressive disorder, recurrent, severe with psychotic symptoms	TMS may be considered as part of a multidisciplinary plan for severe cases (clinical judgment required)
`F34.1`	Dysthymia (persistent depressive disorder)	Chronic depressive disorders may be treated with TMS in selected patients
`G25.0`	Essential tremor	Not an indication for depression TMS but included here as a differential/neuromodulation-related diagnosis where brain stimulation modalities are relevant (providers document exclusions)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90867`	Therapeutic repetitive transcranial magnetic stimulation (TMS); initial one or more treatment sessions including cortical mapping and motor threshold determination, delivery and management	Primary procedure code for the initial TMS treatment session; includes mapping and thresholding
`90868`	Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent delivery and management, per session	Used for follow-up TMS treatment sessions after the initial `90867` session
`90869`	Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent delivery only, without management services, per session	Used when only stimulation delivery is billed without management services or physician oversight
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	May be used to document and bill brief standardized outcome measures administered during TMS care for tracking response
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	May be used for pre-procedure or follow-up evaluation visits related to the TMS treatment course

CPT 90863: Pharmacologic Management After Psychotherapy

CPT-90865-NARCOTIC-INDUCED-HYPNOSIS-FOR-PSYCHIATRIC-DIAGNOSIS

CPT 90865: Narcotic-Induced Hypnosis for Psychiatric Diagnosis and Treatment

CPT-90868-TRANSCRANIAL-MAGNETIC-STIMULATION-SESSION-MANAGEMENT

CPT 90868: Transcranial Magnetic Stimulation, Subsequent Session

CPT-90869-TMS-SUBSEQUENT-MOTOR-THRESHOLD-REDETERMINATION

CPT 90869: TMS Subsequent Motor Threshold Redetermination

CPT-90870-ELECTROCONVULSIVE-THERAPY-PROCEDURAL-SEIZURE

CPT 90870: Electroconvulsive Therapy to Induce Seizure

CPT-90875-PSYCHOPHYSIOLOGICAL-THERAPY-BIOFEEDBACK-PSYCHOTHERAPY-30MIN

CPT 90875: Psychophysiological Therapy with Biofeedback and Psychotherapy, 30 Minutes

CPT-90876-PSYCHOPHYSIOLOGICAL-THERAPY-BIOFEEDBACK-PSYCHOTHERAPY-45MIN

CPT 90876: Psychophysiological Therapy with Biofeedback, 45 Minutes

CPT-90880-HYPNOTHERAPY-PSYCHOTHERAPY

CPT 90880: Hypnotherapy Psychotherapy

CPT-90882-ENVIRONMENTAL-COORDINATION-PSYCHIATRIC-CARE

CPT 90882: Environmental Coordination for Psychiatric Care

CPT-90885-PSYCHIATRIC-RECORD-REVIEW

CPT 90885: Psychiatric Record Review to Inform Diagnosis and Treatment

Showing 1–10 of 13

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Default — No modifier	Used when no special circumstances apply to the service
`22`	Increased procedural services	Use when the service required substantially greater work than typically required (rare for standard TMS delivery)
`23`	Unusual anesthesia	Use if unusual anesthesia unrelated to the procedure is provided for TMS (e.g., for severe agitation)
`52`	Reduced services	Use when TMS session is partially reduced (e.g., early termination with effective dose not delivered)
`53`	Discontinued procedure	Use when TMS session is started but discontinued due to patient intolerance or adverse event
`59`	Distinct procedural service	Use when TMS is separate and distinct from another service performed same day that is not usually reported together
`62`	Two surgeons	Rarely used; applies if two providers of different specialties shared responsibility for the procedure
`78`	Return to the operating/procedure room for a related procedure during the postoperative period	Use if patient requires an unplanned repeat procedure related to an intra-procedural complication (rare for TMS)
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	Use if an element of the TMS visit is delivered live via telemedicine as allowed by payer policy (limited applicability)
`QX`	Modifier to identify services performed by a qualified non-physician under supervision (when required)	Use when a qualified non-physician clinician performs the TMS procedure under required supervision agreements
`QY`	Certified registered nurse anesthetist service reporting (when applicable)	Use only if anesthesia services by a CRNA are separately reportable with the session
`TC`	Technical component	Use if billing separates technical component (equipment, device) from professional component; applies when facility or vendor bills separately
`26`	Professional component	Use when reporting only the physician professional component of the service (paired with `TC` when split)
`QK`	Medical direction by a physician for two or more qualified individuals	Use when physician directs multiple non-physician operators performing TMS under a medical direction model

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry & Neurology	Psychiatrists commonly evaluate and manage TMS candidates and oversee treatment
2084P0803X	Neuromodulation Specialist	Providers with neuromodulation focus perform mapping and device management
207Q00000X	Physical Medicine & Rehabilitation	Some physiatrists may perform or oversee TMS programs in outpatient settings
363LP0800X	Mental Health Therapist	Behavioral health professionals coordinate psychotherapy alongside TMS treatment
208000000X	Psychiatry	General psychiatric specialty involved in diagnosis, treatment planning, and follow-up

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`F32.1`	Major depressive disorder, single episode, moderate	Common indication for TMS when antidepressant trials have been inadequate
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression is a frequent primary diagnosis for TMS treatment
`F32.2`	Major depressive disorder, single episode, severe without psychotic features	Severe depressive episodes are treated with TMS when other therapies are insufficient or not tolerated
`F33.2`	Major depressive disorder, recurrent severe without psychotic features	Indicates severity and recurrence supporting consideration of TMS
`F33.42`	Major depressive disorder, recurrent, severe with psychotic symptoms	TMS may be considered as part of a multidisciplinary plan for severe cases (clinical judgment required)
`F34.1`	Dysthymia (persistent depressive disorder)	Chronic depressive disorders may be treated with TMS in selected patients
`G25.0`	Essential tremor	Not an indication for depression TMS but included here as a differential/neuromodulation-related diagnosis where brain stimulation modalities are relevant (providers document exclusions)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90867`	Therapeutic repetitive transcranial magnetic stimulation (TMS); initial one or more treatment sessions including cortical mapping and motor threshold determination, delivery and management	Primary procedure code for the initial TMS treatment session; includes mapping and thresholding
`90868`	Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent delivery and management, per session	Used for follow-up TMS treatment sessions after the initial `90867` session
`90869`	Therapeutic repetitive transcranial magnetic stimulation (TMS); subsequent delivery only, without management services, per session	Used when only stimulation delivery is billed without management services or physician oversight
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	May be used to document and bill brief standardized outcome measures administered during TMS care for tracking response
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	May be used for pre-procedure or follow-up evaluation visits related to the TMS treatment course

CPT 90863: Pharmacologic Management After Psychotherapy

CPT-90865-NARCOTIC-INDUCED-HYPNOSIS-FOR-PSYCHIATRIC-DIAGNOSIS

CPT 90865: Narcotic-Induced Hypnosis for Psychiatric Diagnosis and Treatment

CPT-90868-TRANSCRANIAL-MAGNETIC-STIMULATION-SESSION-MANAGEMENT

CPT 90868: Transcranial Magnetic Stimulation, Subsequent Session

CPT-90869-TMS-SUBSEQUENT-MOTOR-THRESHOLD-REDETERMINATION

CPT 90869: TMS Subsequent Motor Threshold Redetermination

CPT-90870-ELECTROCONVULSIVE-THERAPY-PROCEDURAL-SEIZURE

CPT 90870: Electroconvulsive Therapy to Induce Seizure

CPT-90875-PSYCHOPHYSIOLOGICAL-THERAPY-BIOFEEDBACK-PSYCHOTHERAPY-30MIN

CPT 90875: Psychophysiological Therapy with Biofeedback and Psychotherapy, 30 Minutes

CPT-90876-PSYCHOPHYSIOLOGICAL-THERAPY-BIOFEEDBACK-PSYCHOTHERAPY-45MIN

CPT 90876: Psychophysiological Therapy with Biofeedback, 45 Minutes

CPT-90880-HYPNOTHERAPY-PSYCHOTHERAPY

CPT 90880: Hypnotherapy Psychotherapy

CPT-90882-ENVIRONMENTAL-COORDINATION-PSYCHIATRIC-CARE

CPT 90882: Environmental Coordination for Psychiatric Care

CPT-90885-PSYCHIATRIC-RECORD-REVIEW

CPT 90885: Psychiatric Record Review to Inform Diagnosis and Treatment

Showing 1–10 of 13

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 90867: Initial Transcranial Magnetic Stimulation Treatment

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Billing Code Overview

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CPT 90867: Initial Transcranial Magnetic Stimulation Treatment

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 90867: Initial Transcranial Magnetic Stimulation Treatment

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Billing Code Overview

CPT 90867: Initial Transcranial Magnetic Stimulation Treatment

Sign up for cpt 90867 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

When should I bill CPT 90867 versus 90868 or 90869?

What clinical documentation elements are expected when reporting CPT 90867?

Which modifiers might apply to CPT 90867 and when are they appropriate?

Which specialties or provider types are associated with performing and overseeing CPT 90867?

Does the page indicate which payers cover CPT 90867 and are reimbursement amounts provided?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

When should I bill CPT 90867 versus 90868 or 90869?

What clinical documentation elements are expected when reporting CPT 90867?

Which modifiers might apply to CPT 90867 and when are they appropriate?

Which specialties or provider types are associated with performing and overseeing CPT 90867?

Does the page indicate which payers cover CPT 90867 and are reimbursement amounts provided?

References