Deep TMS is delivered on site at Stedfast Psychiatry Palm Beach Gardens, 11641 Kew Gardens Ave, Suite 209. A course is typically 36 sessions of about 20 minutes over 6 to 9 weeks, with no anesthesia and no restriction on driving. Medicare and most commercial plans cover TMS for major depression after prior authorization.
How Palm Beach Gardens patients get Deep TMS
Deep TMS is delivered on site at our Palm Beach Gardens office, 11641 Kew Gardens Ave, Suite 209. Patients from North Palm Beach, Juno Beach, Jupiter, Lake Park and Riviera Beach are usually within 20 minutes. Evaluation, insurance authorization and treatment all happen in one place.
Patients come to the Palm Beach Gardens office for TMS evaluation from PGA National, BallenIsles, Mirasol, Frenchman's Creek and Frenchman's Reserve, and from nearby North Palm Beach, Juno Beach, Jupiter and Lake Park. The office is at 11641 Kew Gardens Ave, Suite 209, close to The Gardens Mall.
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. Any of them can start a TMS evaluation; the course itself is supervised by the Palm Beach Gardens TMS team.
Who qualifies
Deep TMS is for adults with major depressive disorder who have not achieved adequate relief from antidepressant medication, or who stopped medication because of side effects. The STAR*D trial, the largest study of real-world depression treatment, found that only about one third of patients reach remission on their first antidepressant, and the odds fall with each additional medication trial. If you are on your second, third or fourth antidepressant and still symptomatic, you are the kind of patient TMS was built for. Deep TMS is also FDA-cleared for obsessive-compulsive disorder that has not responded to SSRIs and therapy, for depression with significant anxiety symptoms, and as a short-term aid to smoking cessation. It is not appropriate for people with ferromagnetic metal in or near the head, cochlear implants, or certain implanted electronic devices, and we take extra care with anyone who has a seizure history.
How Deep TMS works
Depression is associated with reduced activity in the left dorsolateral prefrontal cortex and disrupted communication between that region and deeper limbic structures. TMS uses electromagnetic induction, the same physics that powers an MRI scanner, to create brief, focused magnetic pulses that pass painlessly through the skull and induce small electrical currents in the cortex beneath the coil. Repeated pulses delivered at a set frequency change how readily those neurons fire, and over weeks of daily sessions the effect accumulates into lasting changes in circuit activity. Deep TMS uses an H-coil built into a cushioned helmet. The H-coil geometry produces a broader and deeper field than the figure-8 coil used in traditional rTMS, reaching about 4 centimeters below the scalp versus roughly 1.5 to 2 centimeters for a standard coil. That matters because the prefrontal regions involved in mood regulation are not confined to the surface. For OCD, a different coil (the H7) targets the medial prefrontal and anterior cingulate cortex, and each session begins with a brief, individualized symptom provocation so that the circuit being treated is active during stimulation.
Only about one third of patients with depression reach remission on their first antidepressant, and roughly one third remain depressed after four medication steps.
Source: STAR*D trial, American Journal of Psychiatry, 2006
In the pivotal multicenter trial of Deep TMS for treatment-resistant depression, 38.4 percent of patients responded and 32.6 percent remitted at week 16, versus 21.4 and 14.6 percent with sham.
Source: Levkovitz et al., World Psychiatry, 2015
In a post-marketing analysis of 1,351 patients treated at 21 clinics, 82 percent of patients who completed at least 30 Deep TMS sessions responded and 65 percent reached remission.
Source: Roth et al., Psychiatry Research, 2023
In the pivotal OCD trial of Deep TMS, 38.1 percent of patients responded at six weeks compared with 11.1 percent on sham, rising to 45.2 percent at one-month follow-up.
Source: Carmi et al., American Journal of Psychiatry, 2019
What a course looks like
Your first appointment is a psychiatric evaluation to confirm the diagnosis, review your medication history, screen for contraindications and complete the rating scales your insurer requires. Once authorization is in place, your first treatment day includes motor threshold mapping: we find the lowest pulse intensity that produces a visible twitch in your hand, and all later sessions are dosed as a percentage of that number. A standard depression course is five sessions a week for six weeks, followed by a taper of two sessions a week for three weeks, 36 sessions in total. Each Deep TMS session lasts about 20 minutes, and you are in and out of the office in roughly half an hour. You stay awake, you can talk to the technician, and you drive yourself to work or home afterward. Most people notice early changes in sleep, energy or concentration around week two or three, with mood improvement building through week four to six. A psychiatrist reviews your scores at least every two weeks and adjusts the plan if needed.
Cost and insurance
Medicare covers TMS for major depressive disorder when the clinical criteria in the Florida Medicare contractor's coverage policy are met. Most major commercial insurers, including Aetna, Cigna, UnitedHealthcare, Florida Blue and Humana, cover TMS for depression, usually after documented failure of two to four antidepressant trials and a trial of psychotherapy, with standardized rating scales such as the PHQ-9 or HAM-D on file. Prior authorization is almost always required, and our TMS coordinator submits it for you. OCD coverage is less consistent and varies by plan. If you are uninsured or your plan excludes TMS, ask our TMS coordinator for current self-pay rates and payment options.
Read the full Deep TMS guide, including cost and insurance, side effects and success rates.
Frequently asked questions
Is Stedfast Psychiatry licensed to provide TMS for Palm Beach Gardens patients?
Yes. Stedfast Psychiatry operates a licensed Deep TMS program under psychiatrist supervision. Any Palm Beach Gardens provider can start the evaluation, and the TMS team at our Palm Beach Gardens center delivers the treatment course.
Do I have to drive to Palm Beach Gardens every day for TMS?
No. Deep TMS is delivered at the Palm Beach Gardens office.
Is TMS covered by my insurance in Palm Beach Gardens?
Medicare and most commercial plans cover TMS for major depressive disorder when you have tried at least two to four antidepressants at adequate doses without enough benefit. Our TMS coordinator submits the prior authorization using your PHQ-9 and medication history. Call (561) 437-2199 to start a benefits check.
How do I get evaluated for TMS from Palm Beach Gardens?
Book a new-patient or TMS consultation through the Palm Beach Gardens office at (561) 437-2199, or request a video visit. The provider reviews your treatment history, screens for contraindications such as metal implants in the head or a seizure history, and if you qualify, the coordinator arranges your mapping session at Palm Beach Gardens.
What is TMS therapy?
TMS stands for transcranial magnetic stimulation. It is an FDA-cleared outpatient treatment that uses a magnetic coil placed against the head to deliver brief pulses into the prefrontal cortex, the region that is underactive in depression. Repeated daily sessions over several weeks change how that circuit fires and relieve depressive symptoms in a majority of patients who have not responded to medication. It is not electroconvulsive therapy and does not require anesthesia.
Does TMS work?
Yes, for most people who complete a course. In controlled trials Deep TMS roughly doubled the response rate compared with sham treatment, and in large real-world registries 60 to 75 percent of patients respond and 30 to 50 percent reach full remission. These are patients who had already failed several antidepressants, so the comparison is against a group with poor odds on medication alone. Results are not guaranteed, and about one quarter of patients do not respond meaningfully.
How many TMS sessions will I need?
A standard Deep TMS course for depression is 36 sessions: five sessions a week for six weeks, then a taper of two sessions a week for three weeks. Each session takes about 20 minutes. The OCD protocol is typically 29 sessions over six weeks. Some patients respond early and some insurers approve a shorter course, but we recommend completing the full protocol because response rates rise with session count.
Is TMS covered by insurance?
Medicare covers TMS for major depressive disorder in Florida when coverage criteria are met, and most major commercial plans do as well. Insurers typically require documentation of two to four failed antidepressant trials, a psychotherapy trial, and standardized rating scales such as the PHQ-9 or HAM-D. Prior authorization is required, and our TMS coordinator handles the paperwork. Coverage for OCD and other indications varies by plan.
TMS for other cities we serve
If you are in crisis, call or text 988 or go to the nearest emergency room. Deep TMS is an FDA-cleared device treatment; results vary. Reviewed by Dr. David Husted.