Pending · due 31 Dec 2026
Rules 1.1.0 · as of 14 Sep 2026
Owen Scott Muir · Said 1 Jan 2026 · owen-2028
Quote
“We will have insurance coverage by a national payor—or two—or Accelerated TMS—in the outpatient clinic setting in 2026. It won’t be broad—it will start with pilots and narrow network deals, but the chips will begin to fall.”
Item 6 of the 2026 predictions list: one or two national payers will cover accelerated TMS in outpatient clinics in 2026, starting with pilots and narrow network deals. Accompanied by a photo caption about training on the Ampa system at what was Fermata, before Radial.
Intake
- EventA proposition written from a template on the asset, with a resolution criterion and a named public source, before the outcome is looked up. The same event resolves every person's items on it. Method ›
- A national US payer covers accelerated TMS in the outpatient clinic setting
- AreaOne of five topic classes: regulatory decisions, clinical trial outcomes, company and market outcomes, payer and policy, practice adoption. Every event has one area. Method ›
- Payer and policy
- DeadlineThe date by which the event must happen for the item to be true. It comes only from the person's words through the anchor table. Method ›
- 31 Dec 2026 AnchorThe fixed table that turns the person's own words ('by 2026', 'Q2', 'within two years') into a deadline. The coder never invents a date. Method › · “in 2026”
- Probability
- 0.90 LexiconThe fixed five-bin table that turns a phrase into a probability. The strongest phrase in the claim sentence decides; coders never read tone. Method › · binOne of five lexicon steps: A 'will' 0.90, B 'probably' 0.70, C 'may' 0.50, D 'unlikely' 0.30, E 'never' 0.10. A stated number goes to the nearest bin for calibration only. Method › A · “We will have insurance coverage by a national payor—or two”
- Base rateThe probability a published external study gives an event of that class and stage, fixed at intake. Halved when the item window is shorter than the class median time to decision. Never learned from the ledger's own items. Method ›
- None in the table
- Tags
- affiliated, retrospective
- Coder BCohen's kappa: agreement between two coders beyond chance, from -1 to 1. Reported for admit, event, deadline, bin and asserts from the second-coder match test. Method ›
- admittedA statement that passed intake: sincere, the person's own claim, forward-looking, inside the five areas, and not excluded by a reason code. Only admitted statements become items. Method › · event E-0050 · deadline 31 Dec 2026 · bin A
Registry entry
A US health payer with national scope covers accelerated TMS delivered in outpatient clinics, through a published coverage policy or a publicly announced pilot or network agreement.
TRUE on the effective date of (a) a published medical policy, bulletin or fee schedule of a US health payer with national scope (a national commercial insurer or a federal program) that lists an accelerated TMS protocol (more than one session per day, e.g. accelerated iTBS or SAINT/SNT) as covered or medically necessary in an outpatient clinic, or (b) a public announcement by such a payer, alone or with a provider, of a pilot or network agreement that pays for accelerated TMS in outpatient clinics. Once-daily TMS coverage, trial-only coverage, case exceptions, a single-state or regional plan, an unpublished contract, or inpatient-only coverage does not count. FALSE at the deadline when no such policy or announcement is dated by then. Resolution source: the payer's policy bulletin or fee schedule, or the payer's or provider's press release for the agreement.
Resolution source: The payer's published medical policy bulletin or fee schedule; payer or provider press release for a pilot or network agreement
Readings: 'or Accelerated TMS' is read as 'for Accelerated TMS' (typo), per the finder and the sentence structure.; 'A national payor—or two' = at least one payer with national scope; a single-state or regional plan does not count.; 'It won't be broad—it will start with pilots and narrow network deals': the forecaster counts pilots and narrow network arrangements as coverage, so a publicly announced pilot or network agreement satisfies the event.; 'Accelerated TMS' = protocols with more than one TMS session per day (accelerated iTBS, SAINT/SNT-type), as in the related proposals new:uhc-covers-accelerated-tms-depression and new:additional-health-plan-covers-accelerated-tms.; 'We' is read as accelerated-TMS providers, which include the forecaster's employer Radial.
How to read
Coder A
Resolution
- Effective deadlineAn item enters the score only when its deadline has passed and the outcome is true or false. A claim already known true still waits for its deadline. Method ›
- 31 Dec 2026
- Outcome1 if the registry event happened on or before the item's deadline, 0 if it did not. Written by a resolver who never sees p. Method ›
- not occurred · checked through 13 Sep 2026
- Resolver note
- Checked national-scope payers as of 2026-09-13. Aetna CPB 0469 lists accelerated TMS incl. SAINT as experimental; Cigna/Evernorth EN0383 (eff. 2026-03-15) lists accelerated protocols (TBS, SAINT, SNT) as experimental; UHC policy 2026T0536W (eff. 2026-02-01) lists theta-burst incl. accelerated protocols as unproven. Medicare pays SAINT codes 0889T-0892T only under OPPS at hospital outpatient sites (Magnus: MA, commercial and Medicaid case by case); this hospital-only payment, in place since 2025, is read as not a coverage policy for accelerated TMS in outpatient clinics. The 2026 accelerated-TMS policies found are regional (Premera eff. 2026-01-01, Highmark draft Jan 2026, BCBS South Carolina May 2026) and excluded. BrainsWay (2026-06-22) says the VA has policy language supporting accelerated TMS but names no published policy; unverified. No national pilot or network agreement found.
- Evidence
- Transcranial Magnetic Stimulation and Cranial Electrical Stimulation - Medical Clinical Policy Bulletin 0469
- Evernorth Coverage Policy EN0383: Transcranial Magnetic Stimulation · 15 Mar 2026
- Transcranial Magnetic Stimulation for Treating Physical Health Conditions (Commercial Medical Policy 2026T0536W) · 1 Feb 2026
- Accelerated SAINT TMS Therapy for Rapid Remission | Providers
- Magnus Medical Announces Uninterrupted 2026 Payment Stability for SAINT Neuromodulation in CMS OPPS Final Rule · 24 Nov 2025
- BrainsWay Reports Favorable Coverage for Accelerated Deep TMS Rises to Over 57 Million Covered Lives · 22 Jun 2026
- Radial Celebrates Blue Cross Blue Shield of South Carolina Decision to Cover TMS for OCD and Accelerated TMS for Depression · 18 May 2026
- Medical Policy 2.01.526: Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders · 1 Aug 2026
How to read
Registry
Receding horizon
Muir promised A national US payer covers accelerated TMS in the outpatient clinic setting 3 times; it has not happened.
Cluster E-0050
Timeline
1 claim against 9 events in the field.
Payer and policy