Alpha Sophia
2026 Market Intelligence Brief · Psychiatry

TMS in America, Mapped

A geographic read on U.S. TMS activity (CPT 90867 / 90868 / 90869), built from all-payor claims on the Alpha Sophia platform. This brief shows the shape of the market — the full extract names every site.

Procedure focus: TMS (rTMS / Deep TMS)
Codes: 90867 · 90868 · 90869
Coverage: All-payor claims
Prepared: 2026
2M+
TMS procedures delivered annually
All-payor, nationwide
2,000+
Active billing sites
Clinics & health systems
50+
States + DC with activity
Coast to coast
~1 in 5
Procedures in the top state alone
Highly concentrated
Key Takeaways
  • The U.S. bills 2M+ TMS procedures a year (CPT 90867 / 90868 / 90869) across 2,000+ sites and 50+ states.
  • Volume is highly concentrated — Utah leads with roughly 1 in 5 U.S. procedures, almost entirely from a single high-volume clinic.
  • About 90% of activity is repeat-delivery sessions (90868); initial treatments (90867) point to ~65,000 new TMS starts a year.
  • The biggest untapped opportunity is demand without supply: clinics with high treatment-resistant-depression diagnosis volume that aren’t billing TMS yet.
The Heat Map

TMS intensity by state

Each tile is a state; darker tiles deliver more TMS. The pattern is what matters here — a dense western and coastal cluster, with a long tail of emerging markets. Hover any state for an approximate read. Clinic-level detail is reserved for the full extract.

U.S. all-payor TMS intensity (CPT 90867 · 90868 · 90869)

Relative shading by total procedures delivered per state
Lower intensity
Source: Alpha Sophia all-payor claims intelligence · Stylized state-level view (teaser)

Leading states by TMS intensity

Ranked by total TMS procedure volume. Exact figures available in the full extract.
Top Providers

Top HCPs billing TMS codes

The highest-volume individual TMS prescribers in the U.S. across CPT 90867, 90868 and 90869 — names anonymized. Specialty, practice, metro, per-code activity and year-over-year trend are shown; full identities (name, NPI, affiliation) and exact volumes are in the report.

1
JR
Dr. J█████ R████████████ TMS CenterPsychiatrist · Lehi, UT
908679086890869
+18%
2
MK
Dr. M████ K████████ Neuro HealthPsychiatric NP · Plano, TX
908679086890869
+12%
3
SP
Dr. S████ P█████████████ TMSPsychiatrist · Pasadena, CA
908679086890869
+9%
4
AL
Dr. A███ L██████████ Health SolutionsPsychiatrist · San Francisco, CA
908679086890869
−4%
5
RT
Dr. R████ T████████ PsychiatryNeuropsychiatrist · Gilbert, AZ
908679086890869
+22%
6
EB
Dr. E███ B█████████████ Health ServicesPsychiatrist · Taunton, MA
908679086890869
+6%
7
CH
Dr. C████ H███████████ TMSPsychiatric NP · Lakewood, WA
908679086890869
+14%
8
ND
Dr. N████ D█████████ NeuropsychiatricPsychiatrist · Seattle, WA
908679086890869
−2%
Every individual TMS prescriber, fully ranked — names, NPIs, specialty, affiliation, exact per-code volumes & year-over-year growth.
Request pricing →
Why This Market Matters

TMS is one of psychiatry's fastest-moving procedure categories

Transcranial magnetic stimulation is a non-invasive, drug-free neurostimulation therapy delivered over repeated outpatient sessions — so a single course generates a long series of billable encounters. It sits at the intersection of three forces reshaping behavioral health: a large treatment-resistant patient pool, a widening set of FDA-cleared indications, and an increasingly favorable reimbursement story.

~30%+
of patients on antidepressants meet criteria for treatment-resistant depression — the core TMS candidate pool.
~9–12%
projected annual growth (CAGR) for the global TMS systems market through the early 2030s.
~2× by ~2030s
the global TMS systems market is forecast to roughly double from its mid-decade size.

The demand driver. At least 30% of people treated with antidepressants don't respond adequately, and across U.S. payers the treatment-resistant share of medication-treated major depression runs from roughly one-fifth (Medicare) to over 40%. That is a large, underserved population for which TMS is an evidence-backed, guideline-supported next step.

The expansion driver. The indication envelope keeps widening: TMS is FDA-cleared for major depressive disorder and OCD, and in 2024–2025 clearances extended to adolescents (ages 15–21) and to accelerated protocols (SAINT-style) that compress an initial course from weeks into days — opening new site types and higher-throughput economics.

The reimbursement driver. Retrospective payer analyses show rTMS for treatment-resistant depression reduces high-acuity utilization and overall payer cost versus untreated patients — strengthening coverage and the case for capacity expansion.

  • Recurring billing. A standard acute course runs roughly three dozen sessions, so each new patient maps to a long tail of repeat-delivery encounters — the volume engine behind these numbers.
  • Concentration + long tail. A handful of high-throughput networks dominate, while hundreds of single-site clinics fill out the map — exactly the targeting nuance the full extract exposes.
  • Device & access landscape. Neuronetics (NeuroStar), BrainsWay (Deep TMS), MagVenture and Magstim compete on coil design, protocol speed and indication breadth.
The Bigger Opportunity

What about the practices that see TMS demand — but don't bill it?

Billing data tells you who delivers TMS today. The real white space is everyone who sees the patients but isn't capturing the procedure. Alpha Sophia layers diagnosis signals on top of procedure claims — so you can find practices and psychiatrists managing high volumes of TMS-eligible patients (treatment-resistant depression, MDD, OCD, heavy antidepressant management) who don't currently bill TMS, or who used to and stopped.

Latent demand

Practices with substantial TMS-eligible diagnosis volume but little or no TMS billing — greenfield targets for a device or new service line.

Lapsed providers

Sites that billed TMS historically but have gone quiet — prime reactivation and win-back candidates.

Underpenetrated metros

Markets with strong TMS-eligible diagnosis volume but few active TMS sites — where new capacity meets unmet demand.

See the demand-vs-supply view in the full extract →
White Space

High-demand clinics not yet billing TMS

Practices with a high volume of treatment-resistant depression and MDD diagnoses that are not currently billing any TMS codes — the clearest greenfield targets for a device or a new service line. Powered by the Alpha Sophia diagnosis-based demand layer.

████████ Behavioral Health · Dallas, TX
Very high TRD dx · 0 TMS claims
███████ Psychiatric Associates · Atlanta, GA
High TRD dx · no TMS billing
██████ Mental Health Partners · Chicago, IL
High MDD/TRD dx · no TMS
███████ Wellness & Psychiatry · Columbus, OH
Rising TRD dx · no TMS
█████ Behavioral Medicine · Charlotte, NC
High TRD dx · lapsed TMS

Hundreds of greenfield TMS targets

See every clinic with high treatment-resistant depression diagnosis volume that isn’t billing TMS yet — ranked by opportunity, with names and locations.

Request pricing →
Snapshot vs. Momentum

This is a single moment. The trend is where the decisions are.

This brief is a point-in-time read. The full report adds year-over-year TMS growth by state and by site — so you can see which markets are accelerating, which have plateaued, and where new patient starts are climbing fastest. Track momentum, not just today's leaderboard.

Get the year-over-year trend report →
🔒 In full report
202220242026
Methodology

How this brief was built

A transparent summary of the data, definitions and limitations behind the figures shown here.

Data source
Alpha Sophia all-payor U.S. medical claims (commercial, Medicare and Medicaid) — procedures actually billed, not survey estimates.
Procedures counted
CPT 90867 (initial, with cortical mapping & motor-threshold), 90868 (subsequent delivery), 90869 (subsequent with re-mapping). Totals sum all three.
Aggregation
Volumes attributed to the billing site (organization NPI) and rolled up to state level for this public view.
New-patient proxy
Initial codes (90867) approximate new TMS starts; 90868 reflects ongoing sessions within a course.
Demand layer
White-space targets use ICD-10 diagnosis signals (treatment-resistant depression, MDD) cross-referenced against TMS billing to surface unmet demand.
Approximation
Figures in this brief are rounded and intentionally approximate. The full extract contains exact, site-level counts.
Coverage & timing
Nationwide, 50 states + DC. A point-in-time snapshot; year-over-year trends are available in the full report.
Limitations
Claims data carries reporting lag and occasional attribution gaps; treat single-site outliers (e.g. a dominant network) with that context.
FAQ

TMS market questions, answered

Quick answers on U.S. TMS volume, billing codes, market size and how to get the underlying data.

How many TMS procedures are performed in the U.S. each year?
Across all payors, more than 2 million TMS procedures (CPT 90867, 90868 and 90869) are delivered annually at 2,000+ billing sites spanning 50+ states and DC, based on Alpha Sophia claims intelligence. The vast majority are subsequent-delivery sessions (90868), reflecting the repeated-session nature of a TMS course.
What are CPT codes 90867, 90868 and 90869?
90867 is the initial TMS treatment, including cortical mapping and motor-threshold determination. 90868 is each subsequent delivery session — the bulk of all TMS volume. 90869 is a subsequent session that also re-determines the motor threshold. Counting 90867s approximates the number of new patient starts.
Which U.S. states have the most TMS activity?
Utah, California, Texas, Florida and Washington lead on total volume, with a pronounced western and coastal concentration. Note that a single large network can dominate a state's totals, so per-capita penetration tells a different — and often more actionable — story.
How big is the TMS market and how fast is it growing?
The global TMS systems market was valued in the ~$1.4B+ range in 2025 and is widely forecast to roughly double into the early 2030s, at an estimated 9–12% CAGR, driven by treatment-resistant depression demand and expanding FDA-cleared indications.
Who are the main TMS device manufacturers?
The leading systems come from Neuronetics (NeuroStar), BrainsWay (Deep TMS), MagVenture and Magstim, competing on coil design, protocol speed and indication breadth.
What conditions is TMS FDA-cleared to treat?
TMS is FDA-cleared for major depressive disorder and OCD. In 2024–2025, clearances extended to adolescents (ages 15–21) and to accelerated, SAINT-style protocols that compress an initial course from weeks into days.
How do I get clinic-level and year-over-year TMS data?
The full Alpha Sophia extract names every billing site with NPIs, parent health systems, addresses, per-code mix, the diagnosis-based demand layer, and year-over-year trends. Request pricing.
What's Included

What you unlock in the full report

The teaser above shows the shape of the market. Here's everything the full U.S. TMS market report delivers.

Every TMS-billing site

All 2,469 organizations — name, NPI, parent health system, and full practice address (city / state / ZIP).

Per-code volume

Exact procedure counts for CPT 90867, 90868 and 90869 at every site (all-payor), plus totals.

Every individual prescriber

The complete ranked list of individual TMS-prescribing physicians (name, NPI, specialty, affiliation) — not just the anonymized top 8.

Network & reach

Affiliated HCP counts and Alpha Sophia profile links for each organization, for account planning.

White-space demand layer

Clinics with high TRD/MDD diagnosis volume and no TMS billing history, plus lapsed billers.

Trends, formats & license

Year-over-year growth by state and site, CSV / XLSX (CRM-ready) export, refresh options and a usage license.

Request the Full Market Extract

Get every TMS site in the U.S. — plus the practices with demand but no TMS billing

This brief shows the shape of the market. The full Alpha Sophia extract gives you the clinic-by-clinic detail — and the demand-vs-supply layer — your commercial team needs to build territories and target the right accounts.

Book an extract scoping call →
✓ Every named billing site ✓ NPIs & parent health systems ✓ Full address & territory data ✓ Per-code mix (90867/68/69) ✓ Diagnosis-based demand layer ✓ Export to Excel / CRM
Custom extracts available for any procedure, CPT/HCPCS set, specialty or geography. · Prefer email? isabel@alphasophia.com
Contact

Prefer to just ask?

Skip the call — email Isabel directly with your scope or questions, and we’ll get the right TMS extract priced and over to you.

isabel@alphasophia.com

This brief presents aggregated, approximate, state-level estimates derived from all-payor claims, for illustration. Figures are directional. CPT® is a registered trademark of the American Medical Association. Source: Alpha Sophia.

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