Montana Medicaid’s Policy 475 sets TMS coverage criteria for treatment-resistant depression, including severe major depressive disorder and prior medication-trial failures.
Montana Medicaid TMS coverage policy
According to the Montana Department of Public Health and Human Services, Montana Medicaid’s Behavioral Health and Developmental Disabilities Division Provider Manual includes Policy 475 for transcranial magnetic stimulation, or TMS. The policy describes coverage criteria for TMS as a treatment for treatment-resistant depression. The department’s policy manual identifies the conditions that must be documented before Medicaid will cover TMS treatment.
The source states that coverage under the policy requires a diagnosis of severe major depressive disorder. It also states that the policy applies TMS coverage criteria in the context of treatment-resistant depression. The Montana Department of Public Health and Human Services published the cited Policy 475 document on October 1, 2025.
Required medication history
According to the department’s policy summary, Medicaid coverage for TMS requires documented failure of at least one medication trial from two antidepressant classes. This medication-trial requirement is listed alongside the diagnosis requirement for severe major depressive disorder.
The source does not describe TMS coverage as automatic for everyone with depression. Instead, it identifies specific criteria that must be met for Medicaid coverage, including the required diagnosis and the documented medication-trial history. The policy is presented in the department’s official Medicaid services provider manual.
What the policy addresses
The Montana Department of Public Health and Human Services describes Policy 475 as addressing TMS coverage for treatment-resistant depression. The source specifically identifies severe major depressive disorder and prior medication-trial failures as the stated coverage criteria.
For people seeking information about TMS, the policy may be relevant to understanding the Medicaid requirements described by the state. The source does not provide additional details in this extract about other coverage questions, treatment decisions, or individual circumstances.
What this means for Montana patients
For Montana patients looking for treatment locally, the directory lists 12 published clinics in Montana. The Montana Department of Public Health and Human Services’ Policy 475 states that Medicaid coverage for TMS requires severe major depressive disorder and documented failure of at least one medication trial from two antidepressant classes.
This is general information, not medical advice.
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This report is educational and is not medical advice. Coverage, availability and eligibility can change; verify details with the named source or your care team.