These are the questions patients ask most often before scheduling at Iris TMS Wellness in Woodland Hills. If your question is not here, call (818) 805-2469. A member of the clinical team will answer directly.
TMS therapy (Transcranial Magnetic Stimulation) is a non-invasive, FDA-approved treatment for major depressive disorder. It uses magnetic pulses to stimulate specific areas of the brain that control mood. The treatment requires no drugs, no sedation, and no surgery. Patients remain fully awake throughout each session and return to their regular activities the same day. The FDA approved TMS for depression in 2008. Since then, millions of TMS sessions have been administered in the United States.
Full overview: What is TMS therapy
.TMS and ECT are entirely different treatments. ECT delivers electrical currents to the brain and requires general anesthesia. It carries a risk of memory loss and requires recovery time. TMS uses magnetic pulses, requires no anesthesia, and carries no risk of memory loss. TMS is an outpatient procedure. ECT typically takes place in a hospital or surgical setting. Most patients who are candidates for ECT are also candidates for TMS, and TMS is generally tried first because the risk profile is significantly lower.
Repetitive TMS, commonly abbreviated rTMS, refers to TMS delivered in repeated pulses during each treatment session. This is the standard form of TMS used to treat depression. The word "repetitive" describes the pulse delivery pattern during a single session, not the overall treatment course. When clinicians and insurance plans refer to TMS therapy for depression, they are referring to rTMS.
Deep TMS uses a specialized coil design that can stimulate brain tissue at greater depths than standard rTMS. It is FDA-cleared for major depressive disorder and OCD. Deep TMS is delivered with an H-coil rather than the figure-eight coil used in standard TMS. The mechanism and patient experience are similar. Both are outpatient procedures with no sedation required. Iris TMS Wellness can advise during the clinical evaluation on which TMS protocol is most appropriate for a patient's specific condition.
During a TMS session, the patient sits in a reclined chair. A magnetic coil is positioned against the scalp, over the left prefrontal cortex. The coil delivers brief magnetic pulses to the targeted brain tissue. Patients hear a clicking sound and feel a light tapping sensation on the scalp during stimulation. The session lasts 20 to 40 minutes. No sedation is used. Patients are alert and can listen to music or simply rest. After the session ends, patients leave immediately and return to work, driving, or any other regular activity.
The first TMS appointment is a mapping session, not a standard treatment session. Dr. Elena Kapustina or the clinical team determines the correct coil placement on the patient's scalp and identifies the patient's motor threshold, which is the precise level of magnetic stimulation the brain requires. This mapping session typically takes 60 minutes. It establishes the treatment parameters used for every subsequent session.
A standard TMS treatment course includes 20 to 36 sessions delivered over 4 to 6 weeks. Sessions are scheduled five days per week. Most patients begin noticing changes in mood, energy, or sleep quality within 2 to 4 weeks of starting treatment. Some patients notice improvement earlier. The clinical team at Iris TMS Wellness monitors progress throughout the course and adjusts the protocol as needed.
Yes. TMS therapy does not interfere with work, school, or daily responsibilities. Sessions are 20 to 40 minutes, five days per week. Many patients schedule sessions early in the morning or during a break in their workday. There are no restrictions on activities between sessions.
After completing the primary treatment course, most patients have a follow-up evaluation with Dr. Kapustina to assess results. Some patients complete a brief maintenance schedule of one to two sessions per month to sustain their improvement. Others achieve full remission and do not require further TMS sessions. Retreatment, meaning a second full course of TMS, is available for patients whose symptoms return after a period of remission. Retreatment response rates are comparable to or higher than initial treatment outcomes.
TMS therapy has a clinical response rate of 50% to 60% for major depressive disorder, meaning more than half of patients experience significant symptom reduction. Approximately 30% to 35% of patients achieve full remission, meaning their depression scores fall into the non-depressed range. A 2018 study published in Brain Stimulation found that 62% of responders maintained their improvement at 52 weeks without additional treatment. Results vary based on the severity of depression, medication history, and consistency of treatment attendance.
Yes. TMS is one of the most studied treatments for treatment-resistant depression (TRD). Research published in the Journal of Affective Disorders shows TMS response rates of 38% to 44% in patients formally diagnosed with treatment-resistant depression, defined as failure to respond to two or more antidepressant medications at adequate doses. TMS is often recommended as the next step for patients who have exhausted medication options, because it operates through a different mechanism than pharmaceutical antidepressants.
Most patients who respond to TMS maintain their improvement for at least 12 months after completing treatment without additional sessions. A study in Brain Stimulation (2018) found that 62% of responders maintained their response at one year. Some patients return for a second course of TMS (retreatment) when symptoms begin to return. For many patients, TMS provides lasting results that reduce or eliminate the need for ongoing antidepressant medication.
TMS and antidepressants treat depression through different mechanisms and are not directly comparable in all patient populations. For patients who have not responded to medication, TMS consistently outperforms adding another antidepressant. California TMS Clinics' data and published research show TMS success rates of 50% to 75% in real-world clinical settings, while antidepressant response rates in treatment-resistant populations drop significantly below 40%. For patients without prior medication failure, either approach can be appropriate depending on clinical circumstances.
Yes. TMS therapy has a well-established safety profile supported by more than three decades of clinical research and over a decade of post-approval real-world use since 2008. The most common side effect is mild scalp discomfort or a tapping sensation during treatment, which typically decreases after the first few sessions. TMS has no systemic side effects because no drugs enter the body. It does not cause memory loss. The risk of seizure associated with TMS is approximately 0.1%, making it one of the safest available interventions for depression.
The most common TMS side effects are mild and temporary. They include scalp discomfort or tingling at the coil placement site, a light headache during or immediately after the session, and facial muscle twitching during stimulation. These effects typically subside within minutes of the session ending. Most patients stop experiencing discomfort entirely after the first five sessions. TMS does not cause weight gain, sexual dysfunction, emotional blunting, or any of the systemic side effects associated with antidepressant medications.
Seizures during TMS therapy are rare. The estimated risk is approximately 0.1% of patients, or roughly 1 in 1,000. This risk is lower than the seizure risk associated with several antidepressant medications. Patients with a pre-existing seizure disorder or epilepsy are excluded from TMS for safety reasons. Dr. Kapustina reviews each patient's full medical history before treatment begins to identify and manage any safety considerations.
Yes. TMS is safe for older adults and is one of the few depression treatments that does not interact with existing medications. Seniors who take multiple prescriptions, including blood pressure medications, pain medications, or other psychiatric drugs, can receive TMS without adjusting their current regimen. The absence of drug interactions is one of the primary reasons TMS is particularly well-suited for Medicare-eligible patients.
Yes. TMS is not appropriate for patients who have metallic implants in or near the head, including cochlear implants, cardiac defibrillators, deep brain stimulators, or aneurysm clips. Patients with a history of seizures or epilepsy, active psychotic symptoms, dementia, or a history of severe head trauma or central nervous system tumors are also excluded. Patients with hip replacements, dental fillings, and metal implants below the neck are generally safe for TMS. Dr. Kapustina confirms eligibility through a full medical history review before treatment begins.
Yes. Medicare Part B covers TMS therapy for patients with severe major depressive disorder who have not responded adequately to antidepressant medication. Coverage includes up to 6 weeks of daily outpatient sessions. In 2026, the Medicare Part B annual deductible is $283. After meeting the deductible, patients pay 20% coinsurance per session; Medicare pays 80%. Patients with Medigap supplemental coverage may have their coinsurance covered, reducing out-of-pocket cost to $0.
Full Medicare TMS coverage details
Yes. Most major commercial insurance plans in California cover TMS therapy for major depressive disorder when patients meet their plan's criteria. Plans that commonly cover TMS include Aetna, Cigna/Evernorth, Blue Cross Blue Shield (Anthem), UnitedHealthcare/Optum, Humana, Magellan Health, Carelon Behavioral Health, and Health Net. Iris TMS Wellness verifies coverage for each patient before treatment begins and handles prior authorization directly.
Out-of-pocket cost varies by plan. Medicare patients pay 20% coinsurance after meeting the $283 annual deductible. Patients who have already met their deductible for the year may owe only their coinsurance. Commercial insurance patients typically pay a copay per session (often $20 to $50) or a coinsurance percentage, depending on their plan structure. Iris TMS Wellness provides a written cost estimate to every patient after benefits verification is complete. There are no surprise bills.
Most insurance plans, including all Medicare Advantage plans, require prior authorization before TMS treatment can begin. Prior authorization means the insurance carrier reviews the patient's clinical records and confirms that TMS is medically necessary. Iris TMS Wellness's insurance team manages the entire prior authorization process. Most authorizations are approved within 5 to 10 business days. Patients do not begin treatment until authorization is confirmed.
Prior authorization typically requires documentation of a confirmed major depressive disorder diagnosis (per DSM-5-TR), records of at least one failed antidepressant medication trial at adequate dose and duration, and a prescription or referral from a licensed psychiatrist (MD or DO). Iris TMS Wellness's clinical team assists with gathering and organizing all required documentation. Patients do not need to prepare this independently.
Yes. Medicare Advantage (Part C) plans must provide at least the same level of TMS coverage as Original Medicare Part B. Out-of-pocket costs and prior authorization requirements vary by plan. Some Medicare Advantage plans have different copay structures than Original Medicare. Iris TMS Wellness verifies coverage for all Medicare Advantage plans before treatment begins.
An initial denial does not mean permanent denial. Many TMS coverage denials are reversed on appeal when additional clinical documentation is submitted. Iris TMS Wellness's insurance team assists with the appeal process, including preparing supporting documentation and responding to carrier requests. If the appeal is unsuccessful, self-pay options are available. Call (818) 805-2469 to discuss your specific situation.
TMS therapy is FDA-approved for major depressive disorder (MDD). It is also used under evidence-based clinical judgment for treatment-resistant depression, anxiety disorders, OCD, and PTSD. TMS is particularly well-established for patients who have not responded to antidepressant medication. At Iris TMS Wellness, Dr. Elena Kapustina evaluates each patient individually to determine whether TMS is appropriate for their specific diagnosis.
Yes. TMS targets brain circuits involved in both mood and anxiety regulation. Many patients receiving TMS for depression also experience significant reductions in anxiety symptoms during the same treatment course. Generalized anxiety disorder (GAD), social anxiety, and panic disorder have all shown clinical response to TMS in published research, though insurance coverage for anxiety as a primary diagnosis varies by plan.
TMS shows clinical benefit for PTSD symptoms, including hypervigilance, intrusive thoughts, and emotional reactivity. Research supports TMS as an adjunct treatment for PTSD, particularly in patients who also carry a depression diagnosis. PTSD is not currently an FDA-approved indication for TMS, but off-label clinical use is supported by published evidence. Neurofeedback therapy is also effective for PTSD and is available at Iris TMS Wellness for patients who prefer or benefit from a combined approach.
Yes. Deep TMS received FDA clearance for obsessive-compulsive disorder (OCD) in 2018. Standard repetitive TMS also shows benefit for OCD symptoms in published research, though the evidence base is stronger for deep TMS in this indication. If you are seeking TMS for OCD at Iris TMS Wellness, Dr. Kapustina discusses the clinical options, evidence levels, and expected outcomes during the intake evaluation.
Yes. TMS is one of the most effective depression treatments available for older adults specifically because it is drug-free and does not interact with existing medications. Late-life depression often goes undertreated because seniors cannot tolerate antidepressant side effects or because antidepressants interact with medications taken for other conditions. TMS bypasses both problems. Medicare covers TMS for qualifying seniors. Iris TMS Wellness serves a high proportion of Medicare-eligible patients and has direct experience with late-life depression presentations.
Neurofeedback therapy is a biofeedback technique that uses real-time EEG (electroencephalogram) monitoring to show patients their own brainwave activity on a screen. Patients learn to shift specific brainwave patterns associated with their symptoms by responding to audio or visual feedback during the session. Over multiple sessions, the brain learns to self-regulate more effectively. Neurofeedback is used for anxiety, PTSD, ADHD, sleep disorders, and cognitive performance. It is non-invasive, drug-free, and has no significant side effects.
TMS delivers magnetic pulses to stimulate specific brain regions directly. Neurofeedback uses EEG feedback to teach the brain to regulate its own activity over time. TMS is an active stimulation; neurofeedback is a learning process. TMS is FDA-approved and widely covered by insurance for depression. Neurofeedback is not currently covered by most insurance plans and is offered as a cash-pay service. The two treatments serve overlapping but distinct patient needs and can be used together at Iris TMS Wellness when appropriate.
Neurofeedback therapy is not currently covered by Medicare or most commercial insurance plans. It is offered at Iris TMS Wellness as a cash-pay service. During the clinical evaluation, Dr. Kapustina discusses whether neurofeedback, TMS, or a combination of both is the most appropriate approach for your specific condition and goals.
Yes. Iris TMS Wellness offers both treatments within the same practice. For some patients, combining TMS and neurofeedback produces better outcomes than either treatment alone. TMS addresses the neurological basis of depression through direct stimulation. Neurofeedback builds self-regulation skills that can extend and maintain the gains achieved through TMS. Dr. Kapustina determines during the clinical evaluation whether a combined approach is appropriate for each individual patient.
Call Iris TMS Wellness at (818) 805-2469 or submit your insurance information through the online benefits form. The team verifies your coverage within 24 to 48 hours and provides a written cost estimate. After verification, you schedule a clinical evaluation with Dr. Elena Kapustina, PsyD. If TMS is appropriate, treatment typically begins within two weeks of your first call.
A referral is not required to contact Iris TMS Wellness or verify your insurance benefits. However, most insurance plans and all Medicare coverage for TMS require a prescription or referral from a licensed psychiatrist (MD or DO) as part of the prior authorization process. Iris TMS Wellness can advise you on how to obtain this if you do not currently have a psychiatrist or can coordinate with your existing care team.
Iris TMS Wellness is located at 20300 Ventura Blvd, Suite 275, Woodland Hills, CA 91364. The clinic is in the San Fernando Valley on Ventura Blvd., easily accessible from Woodland Hills, Tarzana, West Hills, Calabasas, Canoga Park, and Encino. Free parking is available on site. Most patients travel 10 to 20 minutes to reach the clinic.
There is no waitlist at Iris TMS Wellness. Most patients complete benefits verification within 24 to 48 hours, receive prior authorization within 5 to 10 business days, and begin treatment within two weeks of their first contact with the clinic. Patients who need to start treatment quickly are encouraged to call directly at (818) 805-2469.
Yes. Call (818) 805-2469 during clinic hours, and a member of the Iris TMS Wellness team will answer your questions directly. There is no obligation to schedule or commit to treatment after the call. If you have questions about candidacy, cost, your specific insurance plan, or what to expect from TMS, a phone call is the fastest way to get accurate answers.