CPT® Code 90867 is used to report the initial repetitive transcranial magnetic stimulation (rTMS) treatment session, including treatment planning, motor threshold determination, mapping, delivery, and management.
rTMS is a noninvasive neuromodulation treatment that uses magnetic pulses to stimulate targeted areas of the brain. The initial session establishes treatment parameters and delivers the first treatment under the appropriate clinical protocol.
Key Facts About CPT® 90867
- Service type: Psychiatric/neuromodulation treatment
- Procedure: Initial repetitive TMS treatment
- Includes: Mapping, motor threshold determination, treatment delivery, and management
- Purpose: Establish and deliver the initial rTMS treatment
- Common specialty: Psychiatry and behavioral health
- Provider type: Physician or qualified healthcare professional
Common clinical uses:
- Major depressive disorder
- Treatment-resistant depression
- Other psychiatric conditions when rTMS is clinically indicated and appropriately authorized
When to Use CPT® 90867
CPT 90867 may be reported for the initial rTMS treatment session when the provider performs the required mapping and motor threshold procedures along with treatment delivery and management.
Examples:
- Beginning an rTMS treatment course for a patient with treatment-resistant depression
- Establishing the patient's motor threshold and treatment location during the first session
- Delivering the initial therapeutic stimulation after treatment parameters have been established
Subsequent rTMS treatment sessions may be reported using the applicable follow-up rTMS codes when the requirements are met.
Documentation Requirements
Documentation supporting CPT 90867 should include:
- Patient identifiers and date of service
- Diagnosis and clinical indication for rTMS
- Relevant psychiatric history and treatment history
- Medical necessity for rTMS
- Motor threshold determination
- Treatment mapping and stimulation target
- Treatment parameters and settings
- Stimulation delivered
- Patient response and tolerance
- Adverse effects or complications, when applicable
- Ongoing treatment plan
Detailed documentation should establish the medical necessity of rTMS and the components of the initial treatment session.
Reimbursement and Coding Considerations
- CPT 90867 represents the initial rTMS treatment with mapping and motor threshold determination
- Subsequent treatment sessions are reported using applicable rTMS codes
- Payer coverage and medical-necessity requirements vary
- Prior authorization may be required
- Documentation should support the diagnosis, treatment history, clinical need, and treatment parameters
- Practices should verify current payer-specific requirements before submitting claims
Accurate documentation of the initial mapping, motor threshold, treatment parameters, and patient response is important for appropriate coding and reimbursement.
How OptiMantra Supports TMS Treatment Documentation
OptiMantra helps behavioral health practices document psychiatric assessments, treatment procedures, medications, and follow-up care within the patient chart.
With OptiMantra, providers can:
- Document rTMS treatment and clinical indications within the patient chart
- Record psychiatric diagnoses and relevant treatment history
- Document treatment parameters and patient response
- Use customizable chart templates for consistent treatment documentation
- Record follow-up plans and ongoing treatment
Keeping TMS treatment information within the patient chart helps providers maintain consistent documentation throughout a patient's treatment course.
Try OptiMantra for free here!
Disclaimer: CPT® codes are maintained by the American Medical Association. This guide is for informational purposes only and does not replace official coding guidelines or payer policies.
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