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713-489-5000

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Insurance and Fees

Insurance

TMS for depression is covered by many insurance plans, typically with preauthorization. To date, insurance will not pay for more than one treatment a day. Out of pocket cost for a full course of treatment is about $14,000. 

Payment 

We do not participate in or accept payment from any commercial health insurance plans (including Medicaid or Medicare). We made this choice because these plans typically limit the types of treatment offered or the amount of time we are able to spend on your care. Payment is required by cash or credit card at or before the time of service. We accept all major forms of credit cards. Assistance is available to verify coverage for TMS.

Houston Area Mental Health Reduced Fee Options

If our fees are not possible, we have the following resources available. 

Insurance

TMS for depression is covered by many insurance plans, typically with preauthorization. To date, insurance will not pay for more than one treatment a day. Out of pocket cost for a full course of treatment is about $14,000. 

Payment 

We do not participate in or accept payment from any commercial health insurance plans (including Medicaid or Medicare). We made this choice because these plans typically limit the types of treatment offered or the amount of time we are able to spend on your care. Payment is required by cash or credit card at or before the time of service. We accept all major forms of credit cards. Assistance is available to verify coverage for TMS.

Phone and Video Appointment Policy

We prefer that initial appointments be in person in our Houston office. The rapport developed with an in person meeting is an important start to the doctor-patient relationship. Subsequent appointments may be done by phone/video if mutually agreed upon. Standard rates apply to phone/video follow-up. 

Cancellation Policy

If you are unable to make your scheduled appointment, please give us as much notice as possible so that we can fill the time slot with another patient. If you do not cancel within 24 hours of your scheduled appointment, and we are unable to fill the spot, we will need to bill you in full for the missed service.

Payment 

We do not participate in or accept payment from any commercial health insurance plans (including Medicaid or Medicare). We made this choice because these plans typically limit the types of treatment offered or the amount of time we are able to spend on your care.

Payment is required by cash or credit card at or before the time of service. We accept all major forms of credit cards. Assistance is available to verify insurance coverage for TMS, Esketamine, and Spravato medication.

Psychiatrist Appointment – Dr. Al Jurdi or Dr. Marangell

First Visit – $550 (up to 70 minutes)

This is usually the place to start. The psychiatrist will do a full evaluation of your problem from all viewpoints, including medical, psychological, and lifestyle. If needed, we will order blood tests and/or genetic testing (tests billed by the outside lab, and the price is not included in the appointment fee). If you need medication, your psychiatrist will discuss options that fit your life.

Additional Pricing:

  • Follow-up for medication management or miscellaneous – $275 (up to 25 minutes)
  • Extended follow-up – $400 (45 minutes)
  • Follow-up visit  – $500 (1 hour)

For reduced fee resources, click here.

Doctorate-level therapists – Dr. Brissette or Dr. Towns

Pricing:

  • First visit for an individual – $240 (60 minutes)
  • Individual follow-up therapy appointments – $200 (45 minutes)
  • Couple or family appointments  – $325 (1 hour)

Transcranial Magnetic Stimulation (TMS)

For transcranial magnetic stimulation, we are now using neuronavigation based in part on recent data from Stanford. Our opinion of the data is that this can make a substantial difference in outcomes because we are able to target a very specific area of your individual brain based on your individual MRI scan, rather than using an estimate based on distance from the motor cortex or measurements from the exterior of your skull. We do not charge more for neuronavigation, but you will have to get imaging. We have arranged for the cost of both structural and functional MRI scans together to be less than $1000 and sometimes this can be billed to insurance.

The first TMS session is devoted to finding the correct amount of magnetic stimulation that is required to produce a measurable response in your brain. This is called the motor threshold. We use an EMG which is more sensitive than simply looking at the movement of your thumb, which is what less advanced TMS systems do. This first session session typically takes one to two hours and involves both physician and assistant time. The cost for the first setup session is $700. The cost for subsequent treatment sessions is $350. If you would like to use insurance and you have a plan that allows out-of-network treatment, we will work directly with the insurance company to obtain preauthorization before you start treatment. However, you will still need to pay us at the time of treatment and submit the billing statement to insurance for reimbursement. Even with preauthorization reimbursement is extremely variable. Expect the total cost of a course of neuronavigated TMS to be about $1400 plus the cost of imaging. 

Insurance for TMS

TMS for depression is covered by many insurance plans, typically with preauthorization. To date, insurance will not pay for more than one treatment a day. Out of pocket cost for a full course of treatment is about $14,000.

We do not participate in or accept payment from any commercial health insurance plans (including Medicaid or Medicare). We made this choice because these plans typically limit the types of treatment offered or the amount of time we are able to spend on your care.

How often do I need to come in for TMS?

The FDA-approved protocol, which is what insurance is most likely to pay for is daily treatment (ie. 5 days a week for 6 weeks), so 30 sessions followed by 6 taper sessions. A variety of studies have supported accelerated treatment by giving multiple treatments per day, separated by about an hour. In this manner, it is possible to do the full course of treatment in a 5-day period. Some people prefer half days for 2 weeks or so.

Esketamine (Spravato) / Ketamine

We prefer esketamine, brand name Spravato, to ketamine because it is FDA-approved for treatment-resistant depression. Esketamine is a nasal spray that we have used in clinical research trials and now in routine clinical practice since 2016. When esketamine is not an option, we do use ketamine, also by an intranasal route. 

Ketamine has not been studied in long-term use for safety, which is why we prefer esketamine. Esketamine is covered by insurance for patients who have not responded to oral antidepressants and psychotherapy.

Esketamine (Spravato)

We would pursue this route after an evaluation and you would need a PPO and not an HMO insurance type to be covered with us – we are out of network for all insurance, including Medicare. For esketamine, after the cost of the medication is covered by insurance, the charge is $325 for each administration because you need to stay in the office for two hours of monitoring. Therefore, we help with insurance preauthorization for the cost of medication before you start your course of treatment.

The initial treatment course is twice a week for 4 weeks. You are then responsible for the office visit portion of each treatment, which is $325. For the acute course of treatment, twice a week for 4 weeks, this total is $1300. As described below, long-term, less frequent treatment is recommended for responders. 

Everyone is treated in our office in a comfortable private room with knowledgeable and compassionate staff. Payment is due at the time of service, and you’re given a receipt which you may submit to your insurance company for reimbursement. The amount of reimbursement that you may receive is highly variable.

Ketamine

For ketamine administration, we charge $500 per treatment, again, after an evaluation. Treatment is provided in the same manner as for esketamine but the two-hour limit is more flexible for patients who feel well enough to leave in a shorter time. We have found the intranasal route to be as effective as the intravenous route and to be more comfortable for patients. Our doctors are specialists who continue to do research in treatment-resistant depression and we are likely the most experienced group in town for these types of treatments.  

How often do I need to come in for Esketamine (Spravato) / Ketamine?

We follow the FDA-approved protocol, which is twice a week for 4 weeks. If you are well or substantially better, then once a week for 4 weeks, then once or twice a week for a bit (this varies based on how you respond) with the goal of monthly treatment. If you are not well at 4 weeks we stop. 

Esketamine/ketamine prices
Transcranial Magnetic Stimulation (TMS) prices

Phone and Video Appointment Policy

We prefer that initial appointments be in person in our Houston office. The rapport developed with an in-person meeting is an important start to the doctor-patient relationship. Subsequent appointments may be done by phone/video if mutually agreed upon. Standard rates apply to phone/video follow-up. 

Cancellation Policy

If you are unable to make your scheduled appointment, please give us as much notice as possible so that we can fill the time slot with another patient. If you do not cancel within 24 hours of your scheduled appointment, and we are unable to fill the spot, we will need to bill you in full for the missed service.

All fees are payable at the time of service by credit card or HSA. 

How often do I need to come in?

Esketamine/Ketamine

We follow the FDA-approved protocol, which is twice a week for 4 weeks. If you are well or substantially better, then once a week for 4 weeks, then once or twice a week for a bit (this varies based on how you respond) with the goal of monthly treatment. If you are not well at 4 weeks we stop. 

TMS

The FDA-approved protocol, which is what insurance is most likely to pay for is daily treatment (ie. 5 days a week for 6 weeks), so 30 sessions followed by 6 taper sessions. A variety of studies have supported accelerated treatment by giving multiple treatments per day, separated by about an hour. In this manner, it is possible to do the full course of treatment in a 5-day period. Some people prefer half days for 2 weeks or so.

Online and In-Person Appointments Available!

appointments are often available within 7 days
Call 713-489-5000

Esketamine / Ketamine 

We prefer esketamine, brand name Spravato, to ketamine because it is FDA-approved for treatment-resistant depression. Esketamine is a nasal spray that we have used in clinical research trials and now in routine clinical practice since 2016. When esketamine is not an option, we do use ketamine, also by an intranasal route. 

Ketamine has not been studied in long-term use for safety, which is why we prefer esketamine. Esketamine is covered by insurance for patients who have not responded to oral antidepressants and psychotherapy.

Esketamine

We would pursue this route after an evaluation and you would need a PPO and not an HMO insurance type to be covered with us – we are out of network for all insurance, including Medicare. For esketamine, after the cost of the medication is covered by insurance, the charge is $325 for each administration because you need to stay in the office for two hours of monitoring. Therefore, we help with insurance preauthorization for the cost of medication before you start your course of treatment.

The initial treatment course is twice a week for 4 weeks. You are then responsible for the office visit portion of each treatment, which is $325. For the acute course of treatment, twice a week for 4 weeks, this total is $1300. As described below, long-term, less frequent treatment is recommended for responders. 

Everyone is treated in our office in a comfortable private room with knowledgeable and compassionate staff. Payment is due at the time of service, and you’re given a receipt which you may submit to your insurance company for reimbursement. The amount of reimbursement that you may receive is highly variable.

Ketamine

For ketamine administration, we charge $500 per treatment, again, after an evaluation. Treatment is provided in the same manner as for esketamine but the two-hour limit is more flexible for patients who feel well enough to leave in a shorter time. We have found the intranasal route to be as effective as the intravenous route and to be more comfortable for patients. Our doctors are specialists who continue to do research in treatment-resistant depression and we are likely the most experienced group in town for these types of treatments.  

How often do I need to come in?

We follow the FDA-approved protocol, which is twice a week for 4 weeks. If you are well or substantially better, then once a week for 4 weeks, then once or twice a week for a bit (this varies based on how you respond) with the goal of monthly treatment. If you are not well at 4 weeks we stop. 

Transcranial Magnetic Stimulation (TMS)

For transcranial magnetic stimulation, we are now using neuronavigation based in part on the recent data from Stanford. Our opinion of the data is that this can make a substantial difference in outcomes because we are able to target a very specific area of your individual brain based on your individual MRI scan, rather than using an estimate based on distance from the motor cortex or measurements from the exterior of your skull. We do not charge more for neuronavigation, but you will have to get imaging. A structural MRI is available for $375 and we now have an agreement with Memorial Herman for both structural and functional imaging will be billed to your insurance. 

The first session is devoted to finding the correct amount of magnetic stimulation that is required to produce a measurable response in your brain. This is called the motor threshold. We use an EMG which is more sensitive than simply looking at the movement. This session typically takes one to two hours and involves both physician and assistant time. The cost for the first setup session is $700. The cost for subsequent treatment sessions is $350. Again, we are out of network for all insurance, including Medicare. Some patients will opt to pay for the treatment series out of pocket. If you would like to use insurance and you have a plan that allows out-of-network treatment, we will work directly with the insurance company to obtain preauthorization before you start treatment. However, you will still need to pay us at the time of treatment and submit the billing statement to insurance for reimbursement. Even with preauthorization reimbursement is extremely variable.

Insurance

TMS for depression is covered by many insurance plans, typically with preauthorization. To date, insurance will not pay for more than one treatment a day. Out of pocket cost for a full course of treatment is about $14,000.

We do not participate in or accept payment from any commercial health insurance plans (including Medicaid or Medicare). We made this choice because these plans typically limit the types of treatment offered or the amount of time we are able to spend on your care.

How often do I need to come in?

The FDA-approved protocol, which is what insurance is most likely to pay for is daily treatment (ie. 5 days a week for 6 weeks), so 30 sessions followed by 6 taper sessions. A variety of studies have supported accelerated treatment by giving multiple treatments per day, separated by about an hour. In this manner, it is possible to do the full course of treatment in a 5-day period. Some people prefer half days for 2 weeks or so.

(713) 489-5000

24 Greenway Plaza #2020
Houston, TX 77046