Please note that Modalis is a private billing clinic. The Acute & Maintenance TMS Prescription Appointments are bulk billed for eligible patients. The TMS Treatment Sessions are not bulk billed; however, eligible patients may receive Medicare rebates for 35 acute and 15 maintenance sessions. While Medicare rebates do not cover the full cost of treatment, they can help reduce your out-of-pocket expenses. For a breakdown of the Medicare criteria and our fees, please see below.
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.
The standard Medicare rebates are listed in the fee tables below. However, 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.
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 Appointment             . | $0 (Bulk Billed) |
| TMS Treatment Sessions | $200 per session (Medicare rebates $156.40 per session)
Rebates are available for up to 35 acute sessions Note: Modalis Adelaide is offering Bulk Billed Treatment |
| Review with Senior TMS Clinician | $0 |
| Review with TMS Specialist (if needed) | From $110 (Medicare rebates from $89.30) |
Maintenance Course: |
|
| TMS Maintenance Prescription Appointment | $0 (Bulk Billed) |
| TMS Treatment Session | $200 per session (Medicare rebates $156.40 per session)
Rebates are available for up to 15 maintenance sessions |
| Review with Senior TMS Clinician | $0 |
| Review with TMS Specialist | From $110 (Medicare rebates from $89.30) |
Modalis provides revised fee options for Aged & Disability Pensioners and Health Care Card (HCC) cardholders upon presentation of a valid Pensioner Concession Card/HCC card; this can be reviewed on a case-by-case basis with our admin team.
Ongoing Treatment (Post-Maintenance): |
|
| Ongoing TMS Prescription Appointment | $145 (Medicare rebates $89.30) |
| TMS Treatment Session | $140 per session |
| Review with Senior TMS Clinician | $0 |
| Review with TMS Specialist | From $110 (Medicare rebates from $89.30) |
Cancellation Policy
At Modalis, we strive to provide our patients with the best possible care. To ensure timely care for all patients, we have implemented the following cancellation policy:
Appointment Cancellation:
- TMS Treatment Appointments: Please provide at least 24 hrs notice for cancellations or rescheduling. Failure to do so will incur a fee of $40.
- Appointments with TMS Specialists: A minimum of 48 hrs notice is required. Failure to do so will incur a fee of 50% of the appointment cost.
No-Show Policy:
Failure to attend an appointment without prior notice will be considered a “Did Not Attend” (DNA). All appointments missed without prior notice will incur the same fees as above, depending on the appointment type. A DNA fee will be charged to the patient’s account and will be added to the next appointment invoice, including for both TMS sessions and appointments with a TMS Specialist.
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.
For appointments with a TMS Specialist, a cancellation fee may be charged when: you cancel within 48 hours, you are a no-show for your appointment, or when you cancel your appointment for a second time.
Contact Information:
To cancel or reschedule an appointment, please call our office or email us. 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.
