Which Type of TMS Is Best? (Comparing Protocols)

Sam Clinch • September 24, 2025

A Guide to rTMS, iTBS, dTMS, aTMS, and More

Transcranial Magnetic Stimulation (TMS) has advanced rapidly in recent years — and with new techniques emerging, you might be wondering which type of TMS is best for you or your loved one.


In this guide, we break down the different TMS protocols, their history, and how they compare in terms of treatment time, insurance coverage, precision, and effectiveness.


Not Sure If Insurance Covers TMS?

Get a personalized estimate - see if you qualify for insurance and what you’d pay without coverage.


A Brief History of TMS

1831 – Michael Faraday discovered electromagnetic induction, laying the foundation for TMS.


1938 – Ugo Cerletti introduced Electroconvulsive Therapy (ECT), often confused with TMS but much more invasive.


1985 – Dr. Anthony Barker developed the first non-invasive TMS device for therapeutic use.


2008 – FDA Approval for TMS in treatment-resistant depression.

Types of TMS Therapy

1. Standard rTMS (Repetitive TMS)

  • What it is: Traditional TMS used in clinics today
  • Treatment time: ~19 minutes
  • Course length: 6+ weeks (30–36 sessions)
  • Insurance: Covered by most plans
  • Precision: Moderate
  • Side effects: Mild to none
  • Best for: Treatment-resistant depression

2. iTBS (Intermittent Theta Burst Stimulation)

  • What it is: Advanced stimulation pattern using fast bursts
  • Treatment time: Only 3 minutes
  • Course length: 6+ weeks
  • Insurance: Covered by many plans
  • Side effects: Low to moderate
  • Best for: Time-sensitive patients, accelerated protocols

3. aTMS (Accelerated TMS)

  • What it is: Multiple iTBS sessions per day over 5 days
  • Treatment time: 3 min sessions every hour for ~9 hours/day
  • Course length: 5 days
  • Insurance: Not covered
  • Side effects: Varies
  • Best for: Rapid results in a single week
  • Inspire TMS Denver offers aTMS at $7000 all-inclusive, with follow-ups included if needed within 6 months.

4. dTMS (Deep TMS)

  • What it is: H-coil helmet for deeper brain stimulation
  • Treatment time: ~20 minutes
  • Course length: 6+ weeks
  • Insurance: Covered
  • Side effects: Higher seizure risk; less targeted
  • Best for: FDA-cleared uses like OCD or smoking cessation
  • Inspire TMS Denver does not currently use dTMS - we prioritize more precise figure-eight coils.

5. nTMS (Navigated TMS)

  • What it is: Uses 3D spatial tracking and MRI targeting
  • Treatment time: Varies by coil
  • Insurance: Not covered
  • Precision: High
  • Side effects: Low
  • Best for: Academic/research settings, not standard care yet

What Does Inspire TMS Denver Offer?

At Inspire TMS Denver, we currently provide:


  • Standard rTMS – reliable and covered by all insurers
  • iTBS – faster sessions, increasingly insurance-approved
  • aTMS – a private-pay, 5-day accelerated protocol


We do not offer:


  • dTMS (H-coil)
  • nTMS (MRI-guided navigation – pending further research)

TMS Types Comparison Table

Type Covered by Insurance Time/Session Full Course Precision Side Effects
rTMS Yes 19 min 6+ weeks + -
iTBS Yes (most) 3 min 6+ weeks + +/-
aTMS No 3 min x10/day 5 days +/- +/-
dTMS Yes 20 min 6+ weeks - +
nTMS No Varies 6+ weeks ++ -

Final Thoughts

Choosing the right type of TMS depends on your specific needs, schedule, insurance, and clinical goals. Inspire TMS Denver is here to help you navigate these choices - we’ll always recommend the safest, most effective treatment plan tailored to your case. Want to learn more? Book a free consultation or take our TMS quiz to find out if TMS is right for you.

Every Question Answered

Want to know more about TMS? Check out this in-depth guide to TMS therapy with transparent and easy to understand explanations about TMS processes, protocols, and treated conditions.

Latest Posts

By Sam Clinch December 13, 2025
Quick summary (the short answers) Medicare: Often covers TMS for treatment-resistant major depressive disorder when the plan’s clinical criteria (such as prior medication trials) are met and prior authorization is approved. Inspire routinely helps patients with Medicare benefits checks and authorizations. Medicaid: Coverage varies by state . Some state Medicaid plans cover TMS with strict medical necessity criteria; others do not. Inspire collects your insurance details and runs a state-specific benefits check. Pre-authorization: Nearly always required. Insurers want documented prior treatment attempts, objective symptom measures (PHQ-9), and a psychiatrist’s letter of medical necessity. Inspire will run the authorization for you once you approve.
By Sam Clinch December 12, 2025
What Inspire TMS Denver accepts and what that means In-network / insurer relationships: Inspire states it accepts major commercial insurers and works with patients to obtain coverage - including Medicare and Tricare, where criteria are met - and the clinic routinely runs benefits checks and prior authorizations on a patient’s behalf. That means you don’t need to guess whether a policy will pay - Inspire will verify for you. Common Medicare / commercial rules (examples): Different payers have specific clinical criteria. For example (from the clinic’s pricing documents): Anthem - typically requires failure of two different antidepressants from different classes (or intolerance). Medicare -may require failure of one previous antidepressant (or intolerance) Tricare - covers TMS when it is medically necessary and prior less-intensive interventions have failed or are inappropriate. These examples illustrate typical insurer frameworks, but your plan may differ. What’s often covered vs not covered: Commonly covered: FDA-cleared TMS for treatment-resistant major depressive disorder when prior treatment criteria are met and prior authorization is approved. Often not covered (or considered “off-label”): accelerated TMS protocols , certain indications (some anxiety/insomnia/experimental uses), and some PTSD/anxiety uses; these may require self-pay or sliding-scale payment. Inspire notes it offers sliding-scale/self-pay for off-label care and for financial hardship.
By Sam Clinch December 12, 2025
How TMS is different: a quick, plain-language explanation TMS uses a magnetic coil to stimulate specific areas of the brain associated with mood and emotional control. It’s non-invasive, does not require anesthesia, and is performed in an outpatient setting. Instead of changing chemistry like antidepressants or providing a rapid but medication-based reset like ketamine , TMS aims to retrain brain circuits by repeatedly activating under-performing regions so they function more normally over time. Inspire’s patient materials stress this neuroplastic, circuit-based approach and describe mapping, stimulation and physician oversight used to personalize treatment.
By Sam Clinch December 11, 2025
What is “treatment-resistant depression” (TRD)? Clinically, TRD is commonly defined as depression that has not sufficiently responded to an adequate trial of two different antidepressants (from at least two different classes) given at therapeutic doses and durations. Some insurers and clinical guidelines use this “two-trial” rule when deciding whether to cover advanced treatments like TMS. Medicare and commercial payers may have slightly different wording (for example, Medicare sometimes requires one failed antidepressant; Anthem often requires two). The key idea is consistent: TRD means standard medication strategies haven’t produced an acceptable response.
By Sam Clinch December 10, 2025
Your main options while you’re in Colorado Short/accelerated courses If you have very limited time, accelerated TMS (iTBS or compressed protocols) lets clinics deliver many sessions over a few days rather than weeks. Inspire offers accelerated regimens (MagVenture-capable) and lists accelerated TMS as an option for patients who need a fast course, but note: accelerated courses are often not covered by insurance and usually require self-pay or sliding-scale arrangements. Maintenance or “rescue” sessions Maintenance or “rescue” sessions If you’ve completed a full course and need occasional boosters to maintain gains while away, maintenance TMS (weekly, biweekly, or monthly sessions) is common. Clinics also provide rescue or extension courses when symptoms re-emerge. Maintenance often requires a clinician discussion to set frequency, and many insurers do not routinely cover maintenance so clinics may offer packages or discounted session bundles. Full course continuation If your original acute course was interrupted, many clinics will pick up or adjust your plan; this typically requires review of previous mapping and progress measures and coordination with your home TMS provider. Inspire performs mapping and tailors plans to each patient’s needs.
Soldiers in uniform seated in a circle; one person comforts another, all in a support group setting.
By Sam Clinch December 9, 2025
Short answer: Yes — Transcranial Magnetic Stimulation (TMS) is increasingly used to treat PTSD symptoms, and many patients report improvements in intrusive memories (flashbacks), hypervigilance and reactivity. At Inspire TMS Denver we tailor TMS protocols to each person’s needs and monitor results closely, offering standard and advanced TMS options for trauma-related symptoms.
Woman in blue scrubs smiles in front of an
By Sam Clinch December 9, 2025
Who is this page for? If you’re searching “ TMS therapy near me ” because medications or therapy haven’t worked, this guide walks you through what TMS is, the types of TMS offered at Inspire TMS Denver, who qualifies, what a typical course looks like, cost & insurance realities, and real patient experiences so you can decide whether to book a free consultation. Inspire is a doctor-led clinic that specializes in evidence-based TMS and personalized care.
By Sam Clinch November 20, 2025
Recognizing the Signs of Bipolar Disorder Bipolar disorder is often misunderstood or misdiagnosed due to its fluctuating nature. Common signs include: Periods of extreme energy or euphoria (mania or hypomania) Sudden shifts to sadness, fatigue, or hopelessness (depression) Difficulty concentrating or making decisions Sleep disturbances (sleeping too much or too little) Impulsive or risky behavior Feelings of irritability or agitation  While everyone experiences mood shifts occasionally, those with bipolar disorder often find these changes disruptive to work, relationships, and daily life.
By Leo Cook November 18, 2025
If you’re struggling with depression, you’re not alone - and you’re likely asking: What actually works? That’s where TMS (Transcranial Magnetic Stimulation) enters the conversation. Let’s break down how effective TMS really is - nationally and here at Inspire TMS Denver .
By Sam Clinch November 18, 2025
Understand Eligibility, Insurance, and Whether TMS Might Be Right for You
Show More