Compare Treatments | Houston Mind & Brain

Treatment	How it works	Typical setting	How fast can it work	Duration of the course	Insurance	Best when...
TMS (standard)	Magnetic pulses stimulate mood circuits (non-drug).	Outpatient clinic, daily sessions (weekdays).	Weeks (many see change in 2–4 weeks).	~4–6 weeks (typical).	Often covered when criteria are met; HMB handles benefits/prior auth.	You want non-drug treatment or have tried meds without benefit.
Accelerated TMS	Same mechanism; more sessions/day to compress the course.	Condensed in-clinic blocks (days).	Faster (days).	Intensive short window (e.g., 6 days).	Often self-pay; reviewed at consult.	Need fast response or cannot attend multi-week schedule.
Spravato	FDA-approved intranasal esketamine — modulates glutamate and promotes neuroplasticity. REMS program.	In-clinic nasal dosing + ~2-hour observation.	Often hours–days for early effects.	Induction (weeks) → optimization → maintenance.	Frequently covered if criteria met; REMS adds documentation. HMB helps with auth.	TRD where rapid relief is desirable and REMS logistics acceptable.
Ketamine	NMDA antagonism → glutamate/AMPA effects → neuroplasticity. Off-label intranasal racemic ketamine; other routes used in practice.	In-clinic dosing & observation (route-dependent).	Often hours–days.	Varies by protocol (induction + maintenance).	Billing varies — racemic ketamine often self-pay or billed differently; HMB provides estimates.	Need rapid relief and/or off-label flexibility; good KAP candidate.
KAP	Combines a ketamine dose with structured psychotherapy to use the neuroplastic window for change.	Prep/integration via telehealth or in-person; dosing in-clinic.	Symptom relief can be rapid; therapy consolidates gains.	Programmatic — several dose + integration sessions.	Billing varies; psychotherapy and drug/observation billed per clinic rates. HMB provides estimates.	Want medication + therapy intentionally paired to deepen and sustain change.
Psychotherapy	Emotion-focused, goal-directed therapy (ISTDP) or other evidence-based therapies.	In-person or secure telehealth.	Weekly or as recommended.	Weeks–months depending on course.	Frequently covered by insurance; HMB verifies benefits and offers cash options.	Want to address psychological drivers, learn skills or integrate gains from procedural treatments.
Medication management	Evidence-based prescribing & monitoring; can augment or combine with above.	Office or telehealth visits (MD/NP/PA).	Weeks (depends on medication). Some augmentation strategies speed benefit.	Ongoing as needed.	Covered by insurance; HMB provides benefit checks and written estimates.	Foundational care; often combined with TMS, Spravato, or ketamine.

MD oversight & coordination: Care is planned and coordinated through structured clinical review and team-based case discussion to ensure safe treatment combinations (e.g., medication adjustments that may affect seizure threshold during TMS).

Monitoring: Spravato and ketamine require in-clinic observation due to dissociation and blood pressure effects. TMS requires motor-threshold mapping and routine safety screening. Psychotherapy and medication management require standard clinical monitoring.

Insurance & cost: Standard TMS and Spravato are commonly covered when medical necessity criteria are met; accelerated TMS and racemic ketamine are often self-pay. HMB verifies benefits, manages prior authorization, and provides written cost estimates. Transparent cash rates are available.

Failed multiple antidepressants, wants non-drug option: Consider TMS (standard) or accelerated TMS if schedule is a barrier.
Rapidly worsening depression / suicidal thinking needing fast relief: Consider Spravato or ketamine (with urgent medical oversight), combined with safety planning and follow-up.
Want medication + deep psychotherapy to change patterns: KAP (ketamine + integration) or medication augmentation + psychotherapy.
Primarily cognitive complaints with mood impact: Add cognitive testing to guide whether TMS/medication/therapy is most likely to help.

Do you accept Medicaid?
No - we accept Medicare but do not accept Medicaid. If you have questions about coverage, call our team and we’ll help.
Will my insurance cover TMS?
Many commercial plans cover standard TMS when medical-necessity criteria are met. Accelerated/fast-track TMS is often self-pay. We verify benefits and submit prior authorization on your behalf.
What if I’m out of network?
This is uncommon because we are credentialed with most plans. If needed, we can provide a superbill for out-of-network reimbursement.
How do I get a written estimate?
Request a free 20-minute expert call. We’ll run a benefits check, explain likely coverage, and send a written estimate of patient responsibility before any treatment.
Can I get sliding scale pricing for TMS?
Yes. We offer sliding scale pricing for eligible patients and can provide a written cost estimate before treatment. To be considered, we’ll ask for proof of income, such as tax documents.

At this time, sliding scale pricing is not available for Medicare patients or for accelerated TMS protocols.