TMS therapy for Pompano Beach — outpatient TRD care, 28 minutes from home.

RECO Integrated Psychiatry's Delray Beach office sits 18 miles up I-95 from Pompano Beach — 28 minutes outside rush — and delivers the FDA-cleared rTMS protocol (10 Hz stimulation of the left DLPFC at 120% of motor threshold, 36 sessions across 6-9 weeks) as a purely outpatient service. Prior authorization, motor threshold mapping, and daily treatment all happen in the same office with the same psychiatry team. No PHP enrollment, no IOP schedule, no facility fee.

The trip from Pompano Beach up to RECO Integrated Psychiatry’s Delray Beach office runs 18 miles north on I-95 — about 28 minutes outside rush. For clients in Cresthaven, Lighthouse Point, Sea Ranch Lakes, and Hillsboro Shores, that drive puts genuine clinical separation between daily life and the treatment chair without leaving the South Florida community they know. The office delivers TMS therapy as a purely outpatient service — no PHP enrollment, no IOP schedule, no facility fee.

Insurance-covered TRD candidacy and how we document it

Commercial coverage for repetitive transcranial magnetic stimulation is governed by treatment-resistant depression criteria that vary in wording but converge in substance. Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans generally require two documented adequate antidepressant trials from at least two pharmacologic classes — adequate dose, at least six weeks per trial, documented adherence — plus a course of evidence-based psychotherapy such as CBT or interpersonal therapy. Sertraline titrated to 200 mg for eight weeks and venlafaxine XR at 225 mg for six weeks, both with PHQ-9 trends recorded, would constitute two adequate trials. A four-week trial of fluoxetine at 20 mg would not.

RECO’s psychiatry team reviews treatment history at the initial consult and reconstructs the pharmacy record when trials have crossed multiple prescribers. For Pompano Beach clients whose care has spanned a primary care physician, an internist, and a prior outpatient psychiatrist, that reconstruction — pharmacy fills, dose titrations, augmentation attempts with aripiprazole or lithium, response measured on PHQ-9 or QIDS-SR — is what the payer reads. Prior authorization is submitted with the intake documentation, and the peer-to-peer review, when requested, is conducted by the treating physician rather than an intake coordinator.

Motor threshold mapping and the first week

Session one is motor threshold determination. A single-pulse TMS coil is positioned over the primary motor cortex, and stimulator intensity is titrated to the minimum output that reliably produces a visible right-thumb twitch — abductor pollicis brevis contraction on five of ten pulses. Treatment intensity is then set at 120% of motor threshold, the FDA-cleared standard for the left dorsolateral prefrontal cortex protocol.

Sessions two through five deliver the full 3,000-pulse protocol at 10 Hz over the DLPFC. Scalp discomfort — a sharp tapping sensation localized under the coil — is most pronounced during the first week and typically attenuates by session six as the trigeminal branches accommodate. Clients drive themselves to and from the office, no sedation is administered, and there is no post-session monitoring requirement. Same-day return to work is routine; door-to-door time is roughly 45 minutes for the standard protocol.

Standard 10 Hz versus intermittent theta burst (iTBS)

The FDA-cleared standard protocol delivers 10 Hz stimulation in 4-second trains separated by 26-second intertrain intervals — approximately 3,000 pulses across 20 to 40 minutes of chair time depending on device platform. Intermittent theta burst stimulation compresses the same therapeutic dose into roughly three minutes of active stimulation. The THREE-D non-inferiority trial (Blumberger et al., Lancet 2018) established equivalent efficacy for major depressive disorder.

For clients commuting up from Pompano Beach five mornings a week, the difference between a three-minute session and a 37-minute session is the difference between treatment being logistically feasible and logistically impossible. Not every commercial plan reimburses iTBS at the standard 10 Hz code rate, and payer policies shift; RECO’s team confirms coverage before the schedule is built. Deep TMS on the Brainsway platform — used for the OCD indication with YBOCS tracking — remains a distinct protocol with its own H-coil geometry and session length.

Response, taper, and the retreatment question

Published response rates for rTMS in treatment-resistant depression sit between 40% and 60% depending on trial population and response definition; remission rates run 25% to 40%. Response typically emerges between sessions 15 and 25, tracked by PHQ-9 and clinician-administered scales at weekly intervals. GAD-7 is followed in parallel for clients with comorbid anxiety, which frequently improves alongside the depressive syndrome.

The final six sessions of the standard course constitute a taper — three per week, then two, then one — designed to consolidate response and reduce early relapse risk. Relapse commonly occurs 6 to 12 months post-treatment; median duration of response in naturalistic follow-up is roughly nine months. Documented responders who relapse are candidates for a second full course, and commercial plans typically cover retreatment when the prior course is documented as a response and the current episode is documented as a distinct relapse. Maintenance TMS — a single session weekly or every other week — is offered case-by-case and is generally self-pay unless specifically authorized.

What to expect at the first visit

The first appointment at RECO’s Delray Beach office is a full psychiatric evaluation, not a TMS setup. A board-certified psychiatrist takes a longitudinal history, reviews prior antidepressant trials and psychotherapy exposure, administers PHQ-9 and GAD-7 baselines, screens for bipolarity with the MDQ, and rules out TMS contraindications — most notably a history of seizure, ferromagnetic hardware in the cranium, or cochlear implants. Clients bring medication list, prior records where available, and insurance card.

If TMS is appropriate, the visit ends with a documented plan and a prior authorization submission the same day. Motor threshold mapping and the first treatment are scheduled once authorization comes back — typically five to ten business days for commercial plans. For clients whose presentation is better served by a Spravato induction, augmentation with quetiapine or aripiprazole, or a switch to an MAOI, that alternate path is discussed at the same visit rather than requiring a separate consult.

Insurance and admissions from Pompano Beach

RECO Integrated Psychiatry is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and Blue Cross Blue Shield plans for the standard rTMS CPT codes — 90867 for motor threshold and initial delivery, 90868 for subsequent sessions, 90869 for reassessment. Coverage specifics — deductible, coinsurance, session cap — are verified before the initial consult so clients arrive with a concrete cost estimate. Self-pay rates for the full 36-session course are published on request.

Scheduling from Pompano Beach neighborhoods is built around the 28-minute drive. Morning slots between 8:00 and 10:30 AM reliably clear rush traffic on I-95 northbound; afternoon slots after 1:30 PM avoid the southbound return backup. Most daily-TMS clients settle into a consistent commute window by the end of the first week, and the fixed-time appointment tends to become one of the more predictable structural anchors of the treatment course.

Serving residents of: Cresthaven, Lighthouse Point, Sea Ranch Lakes, Hillsboro Shores.