It's one of the first questions many patients ask once they've decided to pursue TMS or ketamine: Do I need to be in therapy at the same time? The short answer is no, it's not a requirement. TMS and ketamine are both effective as standalone treatments. But the longer answer is more interesting, and for many patients, more useful. What TMS and Ketamine Do, and What They Don't TMS and ketamine work at a neurological level. TMS uses electromagnetic pulses to modulate activity in targeted brain regions. Ketamine and Spravato act on the glutamate system, promoting neuroplasticity, the brain's ability to form new neural connections. Both can produce meaningful symptom relief, sometimes quickly. What they don't do is address the behavioural patterns, thought processes, and environmental factors that often sit alongside depression, OCD, anxiety, or trauma. They can lift the neurological weight of a depressive episode. They can't, on their own, help you understand why certain situations trigger you, or build the coping skills to manage them. That's what psychotherapy does.

If you're on Medicare and wondering whether your treatment is covered, the answer depends entirely on which treatment you're asking about. TMS and Spravato are both covered; ketamine infusions are not. Here's the full picture. A Quick Note on How Medicare Works Medicare is split into parts, and which part covers your treatment matters. Part A covers inpatient hospital care Part B covers outpatient services, doctor visits, procedures, and drugs that must be administered in a clinical setting Part C (Medicare Advantage) is a private plan that bundles Parts A and B, and must cover at a minimum everything Original Medicare covers Part D covers prescription drugs you take at home TMS and Spravato both fall under Part B, because they require in-clinic administration and supervision, they're billed as outpatient medical services, not prescriptions. That distinction matters for how you're billed and what you'll pay. If you have a Medigap (supplemental) policy, it may cover some or all of the 20% coinsurance that Part B leaves to you, which can significantly reduce your out-of-pocket costs for both treatments. TMS and Medicare: Covered, With Conditions Medicare Part B covers TMS for severe major depressive disorder. The keyword is severe, Medicare's coverage criteria are specific, and not everyone with depression will qualify automatically. To be eligible, you generally need to: Have a confirmed diagnosis of severe MDD as defined by DSM-5 criteria Have tried at least one antidepressant that was either ineffective or intolerable Have a psychiatrist order the treatment following an in-person examination Notably, Medicare's threshold is lower than most commercial insurers - one failed antidepressant trial (or documented intolerance) is generally enough, whereas private plans often require two to four. What you'll pay: In 2026, Medicare Part B carries a $283 annual deductible. Once that's met, Medicare covers 80% of the approved amount for each session; you're responsible for the remaining 20% coinsurance. Medicare Advantage plans must cover at least what Original Medicare covers, though cost-sharing structures vary by plan. If you hold a Medigap (supplemental) policy, it may cover all or most of that 20%, bringing your out-of-pocket cost close to zero. What Medicare won't cover for TMS: OCD, despite TMS being FDA-approved for OCD, Medicare's local coverage determinations have found insufficient evidence to support coverage for that indication. TMS for anxiety, PTSD, or other conditions is also not covered . And certain contraindications, including magnetic implants within 30cm of the coil, or a history of seizures in some cases, will exclude you from coverage.

If you're considering Spravato and you've done any research, you've probably found a lot of clinical information about how it works in the brain. What's harder to find is a plain-language answer to the more immediate question: What is it actually like to sit through a session? Before You Arrive Spravato is FDA-approved for treatment-resistant depression, meaning it's typically prescribed when at least two antidepressants haven't produced adequate relief. Before your first session, you'll have a consultation and medical screening to confirm you're a suitable candidate. There are some contraindications, so this step matters. A few practical things to sort before each appointment: You can't drive yourself home. Spravato can temporarily affect your perception and alertness, so you're required to have someone pick you up - or arrange another way home. This applies after every session, not just the first one. Don't eat a heavy meal beforehand. Nausea is a possible side effect, and arriving on an empty or light stomach helps. Your clinical team will give you specific guidance on this. Plan your day around it. Each appointment runs for at least two hours - the session itself plus the mandatory monitoring period afterwards. Don't schedule anything demanding immediately after.

ONE-D delivers a full TMS course in one supervised day at Elevium Health, NJ. Learn what it is, who it's for, and what to expect.

Medication management is one of the most common (and most misunderstood) services in psychiatric care. It's not just being handed a prescription. Done properly, it's an ongoing clinical relationship built around finding the right medication, at the right dose, with the right support around it, and it's one of the core services we offer at Elevium Health in New Jersey. What Is Medication Management? Medication management is the process of prescribing, monitoring, and adjusting psychiatric medication over time. A psychiatrist doesn't just write a prescription and send you on your way; they review your full history, assess your symptom profile, select the most appropriate medication for your presentation, and then track how you respond. The goal is to find an approach that produces meaningful symptom relief while keeping side effects manageable. That often takes some adjustment. Medications affect people differently, and finding the right fit is rarely a first-attempt certainty. At Elevium, medication management is offered as both a standalone service and as part of a broader treatment plan that may include TMS, Spravato, ketamine therapy, or psychotherapy. Who Is Medication Management For? Medication management is suitable for a wide range of presentations. At Elevium, our psychiatrists work with patients experiencing: Depression Anxiety and social anxiety Bipolar disorder OCD ADHD PTSD and trauma-related disorders Stress and adjustment difficulties Grief and loss Learn More: Compare Treatments It's appropriate for people starting psychiatric medication for the first time, those who have been on medication for years but want more active oversight, and those transitioning between medications or managing complex regimens. It's also worth considering if you're already in therapy or receiving another treatment like TMS and want to explore whether medication could complement what you're doing. How Appointments Work at Elevium Initial consultation The first appointment is about building a full picture. Your psychiatrist will review your medical and psychiatric history, go through any medications you've tried before, understand your current symptoms and how they're affecting your life, and identify any risk factors that might influence which medications are appropriate for you. From that, a treatment plan is developed, including a recommended medication, starting dose, and a follow-up schedule. Sessions are available in-office or via telehealth, giving you flexibility around your schedule. Starting medication Once you begin, you'll receive clear guidance on what the medication does , how long it typically takes to work, and what side effects to watch for. Most psychiatric medications (antidepressants in particular) take several weeks before their full effect becomes apparent. Your psychiatrist will set realistic expectations from the start so you know what the timeline looks like. Follow-up appointments Regular follow-ups are built into the process. These appointments exist to track your progress, check for side effects, and make adjustments where needed. If a medication isn't working as hoped, or if side effects are affecting your quality of life, your psychiatrist will work with you to modify the dose or switch to a different option. Over time, as your symptoms stabilise, the frequency of visits typically reduces, shifting to quarterly or bi-annual check-ins once things are well managed. What If the First Medication Doesn't Work? It's common, and it's expected. Finding the right medication for a given person isn't always straightforward. Different drug classes work through different mechanisms, and individual responses vary considerably based on genetics, history, and other health factors. If a first medication doesn't produce the desired effect (or causes intolerable side effects), your psychiatrist will reassess and recommend an alternative. This trial-and-adjustment process is normal clinical practice, not a sign that medication isn't going to work for you. For patients who have already tried multiple antidepressants without adequate relief, Elevium offers TMS and Spravato as evidence-based options specifically designed for treatment-resistant presentations.