Does my insurance cover TMS therapy?

Most major insurance plans, including Aetna, BCBS Texas, Cigna, and UnitedHealthcare, cover TMS therapy for treatment-resistant depression and OCD when specific clinical criteria are met. Our team handles prior authorization and will confirm your specific coverage before starting treatment.

Is Spravato (esketamine) covered by insurance?

Spravato is FDA-approved for treatment-resistant depression and is covered by many insurance plans, though coverage and prior authorization requirements vary more than for standard medication management. We verify Spravato benefits for your specific plan before your first treatment.

Do you accept insurance for ketamine-assisted psychotherapy or intranasal ketamine?

Racemic ketamine is not FDA-approved for depression and is typically not covered by insurance. We can discuss self-pay pricing during your consultation.

What if you're not in-network with my specific plan?

We may still be able to see you on an out-of-network basis, and can provide documentation (a superbill) so you can seek partial reimbursement from your insurer. In some cases, we can also arrange a single case agreement directly with your insurance company, which allows us to bill at an in-network rate for your specific treatment even though we're not contracted with your plan generally. Contact our office to discuss which option fits your situation.

How long does insurance verification take?

We typically verify benefits within a few business days of scheduling your appointment. If you need to be seen urgently, let our front desk know and we'll prioritize verification.

Does TMS require a referral from another doctor?

Most insurance plans don't require a referral for TMS, but they do require documentation of prior medication trials that didn't work. We can help gather this from your treatment history.

Can I use an HSA or FSA to pay for treatment?

Yes. HSA and FSA funds can generally be used for copays, coinsurance, and self-pay treatments like ketamine. Check with your plan administrator for specifics on what's eligible.

What happens if my insurance denies prior authorization for TMS or Spravato?

If a prior authorization is denied, our clinical team can submit additional documentation or appeal the decision. We'll walk you through your options, including whether a different treatment path makes sense in the meantime.

Do you require payment at the time of service?

Copays and any patient responsibility not covered by insurance are collected at the time of service. We'll let you know your expected costs in advance whenever possible.

Houston Psychiatrists Accepting Insurance

Houston Mind & Brain is in-network with most major insurance carriers, which means psychiatric evaluation, medication management, and — for many patients — advanced treatments like TMS therapy and Spravato can be accessed without paying entirely out of pocket. Below, we've listed every carrier and plan we currently accept, along with what's typically covered for each type of treatment we offer. Because insurance networks and specific plans change throughout the year, we recommend calling or texting our office to confirm your exact plan.

Aetna
We are in-network with Aetna's standard commercial plans, including Aetna Choice® POS II, Open Choice® PPO, HMO, Aetna Select℠, and Aetna HealthFund® plans.

Blue Cross Blue Shield of Texas
We accept most BCBS Texas plans, including:

BlueChoice PPO
Blue Premier HMO
Blue Essentials HMO
Blue High Performance Network
Blue Advantage HMO
MyBlue Health
Health Select
WellMed Medicare Advantage HMO
Medicare Advantage HMO and PPO
Dual Eligible Special Needs Plan (D-SNP)
Well Central HMO

Cigna
We are in-network with Cigna Open Access Plus, PPO, HMO, and POS commercial plans.

UnitedHealthcare
We accept UnitedHealthcare and UnitedHealthcare Behavioral Health (Optum) commercial plans, as well as UnitedHealthcare's Texas Exchange marketplace plans.

Medicare
We accept Traditional Medicare and Railroad Medicare.

Other plans we accept

Humana (Medicare plans)
Magellan Behavioral Health
MultiPlan / Claritev
PHCS
TRICARE (through TriWest Healthcare Alliance, West Region)
Oscar Health Plan
Wellcare — currently accepted for Dr. Raymond Cho; the rest of our provider team is completing Wellcare credentialing.

Not every service is covered the same way, and this is where most confusion starts. Here's a breakdown by treatment type:

Psychiatric evaluation and medication management — This is standard-of-care psychiatry and is covered by nearly every plan we accept, typically with the same copay or coinsurance structure as any specialist visit. No prior authorization is usually required.

TMS (Transcranial Magnetic Stimulation) — TMS is FDA-cleared for treatment-resistant depression and OCD, and most major carriers (Aetna, BCBS, Cigna, UnitedHealthcare) cover it once specific clinical criteria are met — most commonly, documentation that you've tried and not responded to a defined number of antidepressant medications (this varies by insurer, typically two to four failed trials). Insurers almost always require prior authorization for TMS, which our clinical team handles directly with your carrier before treatment starts. Authorization can take anywhere from a few days to a few weeks depending on the plan, so we recommend starting this process as early as possible if you're considering TMS.

Spravato (esketamine) — Spravato is FDA-approved for treatment-resistant depression and is covered by many commercial and Medicare plans, though coverage criteria and prior authorization requirements are generally stricter than for oral medications, given its REMS (Risk Evaluation and Mitigation Strategy) requirements and the in-office monitoring involved. Some plans cover the medication itself but bill the monitoring visit separately; our team verifies both components of your specific plan before your first treatment so there are no surprises.

Intranasal (racemic) ketamine and Ketamine-Assisted Psychotherapy — Unlike Spravato, racemic ketamine is not FDA-approved specifically for depression, which means it is considered an off-label treatment and is typically not covered by insurance. Most patients pursuing ketamine treatment with us do so on a self-pay basis. We're happy to discuss pricing and payment options during your consultation.

Therapy and psychotherapy — Covered by most plans we accept, generally under standard outpatient mental health benefits.

When you schedule your first appointment, our team collects your insurance information and contacts your carrier directly to verify your specific benefits — including your copay, deductible status, and whether any of the treatments you're interested in (like TMS or Spravato) will require prior authorization. We handle the back-and-forth with insurance companies so you don't have to. If your plan requires prior authorization for a treatment, we begin that process as soon as it's clinically appropriate, and we'll let you know realistic timelines up front rather than after the fact.

Does my insurance cover TMS therapy?
Most major insurance plans, including Aetna, BCBS Texas, Cigna, and UnitedHealthcare, cover TMS therapy for treatment-resistant depression and OCD when specific clinical criteria are met. Our team handles prior authorization and will confirm your specific coverage before starting treatment.
Is Spravato (esketamine) covered by insurance?
Spravato is FDA-approved for treatment-resistant depression and is covered by many insurance plans, though coverage and prior authorization requirements vary more than for standard medication management. We verify Spravato benefits for your specific plan before your first treatment.
Do you accept insurance for ketamine-assisted psychotherapy or intranasal ketamine?
Racemic ketamine is not FDA-approved for depression and is typically not covered by insurance. We can discuss self-pay pricing during your consultation.
What if you're not in-network with my specific plan?
We may still be able to see you on an out-of-network basis, and can provide documentation (a superbill) so you can seek partial reimbursement from your insurer. In some cases, we can also arrange a single case agreement directly with your insurance company, which allows us to bill at an in-network rate for your specific treatment even though we're not contracted with your plan generally. Contact our office to discuss which option fits your situation.
How long does insurance verification take?
We typically verify benefits within a few business days of scheduling your appointment. If you need to be seen urgently, let our front desk know and we'll prioritize verification.
Does TMS require a referral from another doctor?
Most insurance plans don't require a referral for TMS, but they do require documentation of prior medication trials that didn't work. We can help gather this from your treatment history.
Can I use an HSA or FSA to pay for treatment?
Yes. HSA and FSA funds can generally be used for copays, coinsurance, and self-pay treatments like ketamine. Check with your plan administrator for specifics on what's eligible.
What happens if my insurance denies prior authorization for TMS or Spravato?
If a prior authorization is denied, our clinical team can submit additional documentation or appeal the decision. We'll walk you through your options, including whether a different treatment path makes sense in the meantime.
Do you require payment at the time of service?
Copays and any patient responsibility not covered by insurance are collected at the time of service. We'll let you know your expected costs in advance whenever possible.