How do you facilitate access to interventional treatments such as TMS for patients with difficult-to-treat depression who are on Medicaid?

I think the rules vary by state for Medicaid, but here in MD, we do a consultation appointment and then submit for preauthorization from Medicaid. We typically do not start the treatments until we hear back that the course is approved. Lately, some of our Medicaid patients who have been approved have been granted more than 36 treatments, which has been quite nice if we need to use the extras.

Criteria for Medicaid in Maryland, must have trials from at least 2 different classes of antidepressants of adequate dose and duration. (If the patient had a side effect from a med such that they could not increase the dose or tolerate it for 4 weeks, that usually counts too.)

One other thing, we have a Day Program at our hospital. With Medicaid, the p...