NC H152

Health benefit plans in North Carolina that cover transcranial magnetic stimulation (TMS) must reimburse all properly licensed healthcare providers and facilities for TMS procedures without penalizing them based on their medical specialty

TMS is defined as a noninvasive treatment using pulsed magnetic fields to induce electric current in localized brain regions for treating depression and other mental disorders

Insurers retain discretion over whether to cover TMS, which conditions qualify for coverage, coverage requirements, and reimbursement rates

Prohibited penalties include denial, reduction, or limitations on reimbursement of properly submitted claims; however, rate differences based on network participation, service location, or provider training/certification levels are permitted

Effective October 1, 2025, applying to insurance contracts issued, renewed, or amended on or after that date; also applies to the State Health Plan