U.S. Payers Expand Nurse Practitioner Access to TMS Therapy
Event summary
- Optum Behavioral Health updated its TMS clinical policy in late 2025 to allow psychiatric mental health nurse practitioners (PMHNPs) to administer TMS therapy in states with full practice authority.
- The updated policy applies to commercial plans covering approximately 34.8 million lives.
- Multiple other U.S. commercial payers, Medicare Administrative Contractors, and government payers have adopted similar coverage approaches.
- BrainsWay highlights this trend as a structural shift to improve access to mental health care, particularly in markets with psychiatrist shortages.
The big picture
The shift in payer policies reflects a broader industry trend toward expanding the role of nurse practitioners in mental health care, particularly in response to psychiatrist shortages. This structural change could enhance access to non-pharmacologic treatments like Deep TMS, addressing provider capacity constraints and improving timely access to care. The trend underscores the growing acceptance of nurse practitioners as key providers in mental health treatment.
What we're watching
- Provider Capacity
- How the expansion of nurse practitioner-administered TMS therapy will affect wait times and access to treatment in underserved markets.
- Regulatory Dynamics
- Whether state scope-of-practice requirements will continue to evolve to support broader nurse practitioner involvement in mental health care.
- Market Adoption
- The pace at which additional payers and healthcare systems will adopt policies permitting nurse practitioners to administer TMS therapy.