In November 2021 Medicare introduced partial rebates for patients receiving TMS for treatment-resistant depression. Sessions are now largely covered by Medicare for eligible patients, making TMS a viable and affordable option for everyday Australians.
Medicare Eligibility
Eligibility Criteria:
Currently, patients receiving TMS treatment for depression are eligible for Medicare rebates if they:
- Are 18+ years old
- Are diagnosed with a major depressive episode
- Have not previously received any prior TMS therapy in a public or private setting
- Have adequately* trialled at least 2 classes of antidepressants without receiving satisfactory improvement, unless contraindicated
- Have undertaken psychological therapy, if clinically appropriate
*Medicare currently defines an ‘adequate trial’ of an antidepressant as meeting the following criteria: 1.) The patient’s adherence to antidepressant treatment was formally assessed; 2.) the trialling of each antidepressant medication was at the recommended therapeutic dose for a minimum of 3 weeks; and 3.) where clinically appropriate, the treatment was titrated to the maximum tolerated therapeutic dose.
Available Rebates:
Medicare offers partial rebates for eligible patients for up to 35 sessions (initial acute course), followed by 15 maintenance sessions (4+ months after the acute course) for those patients who have shown improvement following the acute course but subsequently relapsed.
Unfortunately rebates for other conditions are not currently available, although we hope this will change in the future. Individuals who do not meet the Medicare criteria can still receive treatment but will not receive a rebate by Medicare.
TMS Fees
For a breakdown of costs, please see below.
Acute Course: | |
Screening Call | $0 |
Pre-consent Call | $0 |
TMS Prescription (& RMT) appointment . | $240 (Medicare rebates $173.50) |
TMS Treatment Session (Acute course) | $185 per session (Medicare rebates $148.90 per session)
Rebates are available for up to 35 acute sessions |
TMS Final review | $0 – Bulk billed or Free of charge |
Maintenance Course: | |
TMS Maintenance Prescription appointment | $240 (Medicare rebates $173.50) |
TMS Treatment Session (Maintenance course) | $185 per session (Medicare rebates $148.90 per session)
Rebates are available for up to 15 maintenance sessions |
TMS Final review | $0 – Bulk billed or Free of charge |
*We provide revised fee options for pension cardholders; this can be reviewed on a case-by-case basis with our admin team.
Patients who have reached their Medicare Safety Net Threshold may be eligible for larger rebates. Please note: The value and conditions of the rebates provided by Medicare are regulated by Medicare and therefore subject to change.
Cancellation Policy
At Modalis, we strive to provide our patients with the best possible care. To ensure that we can accommodate all patients and maintain our schedule, we have implemented the following cancellation policy:
Appointment Cancellation:
We kindly ask that patients provide at least 24 hours’ notice if they need to cancel or reschedule an appointment. This allows us to offer that time slot to another patient who may need care.
What if I have to cancel due to an emergency or illness?
If you experience an emergency or illness, please contact us as soon as possible. We’ll do our best to work with you and may waive the cancellation fee in those cases.
No-Show Policy:
If a patient does not show up for their appointment without prior notice, it will be considered a “Did Not Attend” (DNA). A DNA fee of $30.00 will be charged to the patient’s account and will be added to the next appointment invoice, including for both TMS sessions and consent appointments.
Repeated Cancellations/No-Shows:
Patients with more than two late cancellations or no-shows may undergo further review. Repeated occurrences could result in additional DNA fees being applied to their next TMS appointment.
Contact Information:
To cancel or reschedule an appointment, please call our office at 08 61663733 or email us at tms@modalis.com.au. We also encourage patients to message us when they need to cancel, as this can help reduce the volume of daily calls.
We appreciate your understanding and cooperation in this cancellation policy, as it helps us provide timely care to all our patients.