Big News: Select Insurers are Starting to Cover SAINT® TMS Therapy - Expanding Access to a Fast, Life-Saving Depression Treatment
Big News: Select Insurers are Starting to Cover SAINT® TMS Therapy - Expanding Access to a Fast, Life-Saving Depression Treatment
September 26
At Acacia Clinics, our mission is simple: to help people live well and find relief—fast. That’s why we were early adopters of SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy), an advanced, individualized form of transcranial magnetic stimulation (TMS) treatment delivered over just five days.
SAINT represents a breakthrough in treating major depressive disorder, especially for those with treatment resistant depression who have not found success with standard antidepressant medication or other depression treatments. Antidepressant medications are typically considered first-line treatment for major depression, but when these and other standard treatments are ineffective, SAINT offers a promising alternative.
Today, we are thrilled to share that select insurers have begun covering SAINT in certain settings, a major step toward broader access for patients who need rapid, evidence-based care. Most insurance companies are beginning to evaluate coverage for advanced TMS protocols like SAINT. Recent federal payment decisions for hospitals and public statements from the device maker indicate expanding coverage pathways, including some Medicare coverage, supported by a growing body of clinical evidence demonstrating SAINT’s effectiveness.
Why SAINT matters for treatment resistant depression
SAINT is not just another TMS protocol; known as the SAINT protocol, it stands out among TMS protocols as a neuroscience-informed, high-dose treatment that uses intelligent neuromodulation therapy to precisely target specific brain regions associated with depression symptoms. Unlike traditional repetitive transcranial magnetic stimulation (rTMS), SAINT employs functional MRI (fMRI) to individualize coil placement, ensuring the electromagnetic coil stimulates the correct brain region—often the dorsolateral prefrontal cortex, which plays a key role in mood regulation. This precision targeting enhances treatment effectiveness by modulating brain activity more accurately. While deep TMS uses specialized coils to reach deeper brain regions and is FDA-approved for conditions like depression, OCD, and smoking cessation, the SAINT protocol leverages advanced neuronavigation and fMRI guidance for highly precise stimulation.
In a randomized, double-blind clinical trial led by Stanford University, SAINT demonstrated markedly larger improvements in depressive symptoms compared to sham treatment. Patients experienced robust symptom reductions at four weeks post-treatment. Earlier open-label studies showed very high remission rates after just a single five-day course, which consists of 50 TMS sessions delivered as 10 sessions per day. Importantly, no negative cognitive effects were detected, highlighting the safety of this intensive protocol. The rapid timeline of SAINT is a game-changer: while standard TMS treatment courses typically require six weeks, SAINT completes treatment in five intensive days. This accelerated TMS therapy uses intermittent theta burst stimulation (iTBS), delivering magnetic pulses in rapid bursts that stimulate nerve cells efficiently and effectively to improve symptoms of major depression. TMS works by using magnetic fields to noninvasively stimulate neural activity in targeted brain regions, helping to alleviate symptoms in conditions such as depression, OCD, and smoking cessation.
What’s changing with insurance
In 2025, the Centers for Medicare & Medicaid Services (CMS) established specific hospital outpatient payments for SAINT treatment days and targeting procedures. This important development signals that payers are beginning to build reimbursement pathways for this innovative brain stimulation treatment. Magnus Medical, the maker of the FDA-cleared SAINT Neuromodulation System, has also announced expectations of selective coverage across hospital and physician-office settings as availability expands. While coverage is still variable by insurance plan and treatment setting, insurance coverage may include initial treatment sessions as well as ongoing or maintenance therapy. These changes represent significant progress toward making SAINT accessible to more patients.
The SAINT Neuromodulation System received FDA clearance in 2022 for adults with major depressive disorder who have not improved satisfactorily with prior antidepressant medication during their current depressive episode. This noninvasive procedure uses an electromagnetic coil to deliver repetitive TMS pulses that stimulate nerve cells in specific brain regions, helping to alleviate depressive symptoms and suicidal ideation without the side effects often associated with electroconvulsive therapy or antidepressant drugs. When starting treatment with SAINT, patients can expect an initial planning session to determine their motor threshold and individualized treatment plan, followed by their first treatment session.
What this means for your depression symptoms care at Acacia
At Acacia Clinics, we are committed to helping you access the best depression treatments available. For patients interested in SAINT, our team will now submit prior authorizations (PAs) when appropriate. A prior authorization is an approval from your health plan that may be required before coverage is granted. While this process can add some waiting time as the insurer reviews clinical information, we handle all the paperwork and keep you updated throughout.
Despite potential delays due to coverage review, our ethos remains unchanged: we prioritize delivering fast relief. If insurance approval takes time, we will discuss alternative options such as self-pay, financing, or timing adjustments so you can start feeling better as soon as possible.
Acacia offers SAINT as an outpatient program designed for individuals seeking transformative care delivered efficiently and safely close to home or while visiting the Bay Area. Each treatment session involves placing the TMS coil on the scalp to deliver magnetic fields that stimulate the dorsolateral prefrontal cortex, improving brain activity related to mood regulation and reducing depressive symptoms. A team of trained medical professionals administers TMS and performs TMS sessions, closely monitoring patient progress and adjusting protocols as necessary to ensure optimal outcomes.
Before starting treatment, all patients are carefully evaluated to determine if they are eligible to undergo TMS at Acacia, based on medical history, clinical assessments, and established criteria.
What to expect from TMS treatment
Transcranial magnetic stimulation (TMS) is a noninvasive procedure designed to help people struggling with major depressive disorder and other mental health conditions. TMS treatment uses gentle magnetic pulses to stimulate nerve cells in specific areas of the brain that are involved in mood regulation. This process aims to improve symptoms of depression and can also be beneficial for certain other mental health conditions.
When you arrive for your transcranial magnetic stimulation TMS session, you’ll be comfortably seated while a trained healthcare provider positions a magnetic coil against your scalp. The device delivers focused magnetic pulses that pass through the skull to stimulate nerve cells in targeted brain regions. Most people describe the sensation as a light tapping or tingling on the scalp, and you remain awake and alert throughout the treatment. Because TMS is a noninvasive procedure, there is no need for anesthesia or recovery time—you can return to your normal activities immediately after each session.
TMS is well-tolerated by most people, with minimal side effects such as mild scalp discomfort or headache that usually resolve quickly. Throughout your treatment, your care team will monitor your progress and adjust the approach as needed to help you achieve the best possible outcome.
If you are considering TMS treatment to help manage major depressive disorder or other mental health conditions, you can expect a safe, supportive, and personalized experience designed to stimulate nerve cells and improve symptoms—helping you move forward on your path to better mental health.
Why choose Acacia for SAINT Therapy
Acacia’s clinicians have been involved with SAINT since the early Stanford studies. In addition, Acacia has participated in ongoing and past clinical trials to advance TMS therapies. Our medical leadership includes co-authors of the landmark randomized trial, ensuring that you are treated by a team deeply versed in the science and day-to-day nuances of delivering this innovative protocol. We are widely recognized as an early, high-experience outpatient program and a premier destination for travelers seeking world-class interventional psychiatry with concierge-level coordination.
Our expertise extends beyond depression to other mental health conditions that may benefit from brain stimulation therapies, such as obsessive-compulsive disorder and traumatic brain injury. We use advanced MRI scans and motor threshold measurements to tailor treatment courses, minimizing scalp discomfort and maximizing effectiveness. Acacia is committed to providing effective treatment for all patients. We use advanced TMS protocols to treat depression and other mental health conditions. Our approach integrates talk therapy and other treatments to provide comprehensive mental health care.
Ready to explore SAINT with Acacia?
If you or a loved one is struggling with treatment resistant depression, we are here to help you navigate insurance coverage, set realistic expectations, and most importantly, start a path toward rapid relief. Contact us today to verify your benefits, begin the prior authorization process, or schedule a consultation.
Key references:
Stanford SAINT/SNT randomized trial and protocol details, including precision targeting and the five-day course: PubMed 34711062 and PubMed 32252538
FDA clearance for the SAINT Neuromodulation System by Magnus Medical: FDA Access Data
2025 CMS hospital outpatient payment for SAINT treatment days and targeting, and manufacturer statements on selective coverage and some Medicare access: Magnus Medical Press Release
Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Ratings; and Hospital Price Transparency: Federal Register
Note: Insurance benefits vary by plan and site of care. Our team will verify your specific coverage and obtain prior authorization where required. As of this writing, insurances that have been approving prior authorizations include Blue Shield Plans such as Blue Cross Blue Shield (outside California), Blue Shield of California, FEP, Premera Blue Cross, Regence Blue Shield, and others.
