TMS is a procedure that uses highly concentrated electromagnetic pulses to specific regions of the brain that regulate mood. During an rTMS session an electrical current passes through a small coil placed close to the scalp. This current induces a magnetic field. The magnetic field can travel through the skull and pass into the brain.

You are immediately excluded from receiving TMS treatment if you:

• Have metal implants in your skull/head.
• Have recently experienced a seizure.
• Have a history of seizures/epilepsy.

You may be excluded if you:

• Have a pacemaker.
• Are pregnant.
• Have a brain injury.
• Other exclusions may apply at the discretion of the psychiatrist.

To be eligible for Medicare rebates for treatment-resistant depression TMS sessions, you must meet the following criteria:

• You have tried two different classes of antidepressant medication that have not worked, or
• You are unable to take antidepressant medications due to severe side effects or allergy, and
• You are over the age of 18, and
• Have a referral from your GP or psychiatrist.

The first appointment is called the TMS “induction,” which includes neural mapping, motor threshold determination, and an initial treatment session where appropriate. During your initial appointment, the treating psychiatrist will map out a region on your scalp that correlates to the dorsolateral prefrontal cortex (DLPFC). Next, the minimum energy needed to stimulate your brain—your resting motor threshold—is determined. Motor threshold determination is done by stimulating the left side of your head over the pre-motor cortex, which controls your right hand. Stimulation will cause your hand to have a single muscle twitch. Once mapping and threshold determination are complete, the initial treatment begins.

Sessions are held 5 times per week (Monday–Friday). Antidepressant effects may be noticed within the first 10–20 sessions. Typically, 20–35 sessions are needed to consolidate the effects, with a full course completed in 1–2 months.

Our clinician will review your treatment regimen and work with you to optimize it and reduce any medication-related risks. In general, you can continue to take your regular medications during your TMS treatment.

The Sherpah Clinic does not charge a gap fee, meaning there is no out-of-pocket cost for TMS.
However:

• There is a circadian monitoring fee of $120 for a wearable device and app used to track treatment response.
• For non-Medicare supported conditions, treatment costs $60 per session.
• Maintenance sessions are also $60 per session.

We offer a 15-minute grace period for late arrivals. If you arrive more than 15 minutes late, we may be unable to provide treatment as it could disrupt the schedule for other patients.

To ensure optimal effectiveness, it’s important to attend all scheduled sessions. If you can’t attend, please inform the clinic at least 48 hours in advance to reschedule. If you miss two consecutive appointments without notice, your specialist may need to re-evaluate your treatment plan.