Together, Expanding Treatment
Options for Your Patients
At River Road TMS, LLC, we believe excellent mental health care is collaborative. We are committed to helping patients when traditional treatment options such as medication and/or psychotherapy have not provided adequate relief.
Our practice provides a welcoming environment, convenient referral and scheduling processes, extended office hours and ample parking — all designed to reduce barriers to care.
Most importantly, we are a team of compassionate and competent TMS providers who provide evidence-based TMS care using NeuroStar Advanced TMS therapy.
We value strong relationships with referring psychiatrists, therapists, psychiatric nurse practitioners, primary care providers, and other mental health clinicians. We believe referring providers should remain active members of the treatment team.
You can pick up the phone and speak directly with our TMS providers or communicate by email (with patient consent). We routinely provide:
Written mid-treatment summaries
Written treatment completion summaries
Collaboration throughout care as indicated
Our goal is simple: support your patient while strengthening—not replacing—the therapeutic relationship you already have with them.
What is TMS?
Candidates and Non-Candidates
What Many Insurers Require
Side effects of TMS
TMS (Transcranial Magnetic Stimulation) is an FDA-cleared, non-invasive treatment that uses targeted magnetic pulses to stimulate specific areas of the brain involved in mood regulation. It is performed in-office while the patient is fully awake, requires no anesthesia, and patients can return to normal activities immediately afterward.
TMS is appropriate for patients with a diagnosis of Major Depressive Disorder who have not achieved satisfactory improvement from prior antidepressant medications. It is also FDA-cleared for anxious depression and OCD. Patients with metal implants in or near the head (excluding dental work) or a history of seizures may not be candidates.
Most commercial insurers and Medicare plans cover TMS therapy. Common requirements include a confirmed diagnosis of Major Depressive Disorder and documented failure of or intolerance to an adequate number of antidepressant medication trials (typically 2–4 trials). Our team handles insurance verification and prior authorization on behalf of your patients.
The most common side effect is temporary pain or discomfort at or near the treatment site (scalp) during therapy that usually resolves within the first week of treatment.
There is a rare risk of seizure associated with TMS therapy that occurs in <0.1% of people.
There is no adverse effect on cognition.
What to Listen For in Conversations with your Patients
“I feel stuck.”
“I don’t want to keep increasing my medications or adding medications.”
“The side effects are harder than the benefits.”
“I’ve tried several medications and nothing seems to work.”
“I want another option.”
How to Explain TMS Simply to Patients
“TMS is an FDA-cleared treatment for depression, depression with comorbid anxiety, and OCD that uses magnetic pulses to stimulate areas of the brain involved in mood. It is performed while you are awake, doesn’t require anesthesia, and you can return to normal activities immediately afterward. TMS is essentially physical therapy for the brain.”
You do not need to know every technical detail to begin the conversation. Often, simply helping patients understand that another evidence-based treatment option exists can be incredibly meaningful.
Common Questions Patients May Ask About TMS
Will it hurt?
Most patients describe treatment as a tapping sensation on the scalp. Mild discomfort can occur initially but typically improves over time. The TMS staff can make adjustments to make it more comfortable.
Will it change my personality?
No. TMS is intended to improve your symptoms—not alter personality.
Will I lose my memory?
No. TMS has not been associated with memory loss and differs significantly from ECT.
Can I drive afterward?
Yes. Patients resume normal daily activities immediately after treatment.
How long are treatments?
Treatment sessions are generally between 19 and 30 minutes.
How often do patients come?
Most treatment courses involve visits five days per week for several weeks, followed by a taper phase in some cases if your insurance requires it.
When do patients notice improvement?
Response timing varies. Some individuals notice changes within several weeks while others improve later during treatment.
Frequently Asked Questions From Referring Providers
Do I continue seeing the patient?
Yes. We strongly encourage patients to continue seeing their therapist and primary psychiatric provider during treatment and collaboration with TMS providers is encouraged as certain medications can impact TMS (ex- benzodiazepines and stimulants).
Do medications need to change?
We typically encourage medication stability whenever possible, though treatment decisions remain individualized. This is where collaboration is key!
Will I receive updates?
Absolutely. We routinely communicate progress throughout treatment via written communication if the patient consents.
Will TMS replace therapy?
No. TMS often works best as part of a broader treatment plan that includes psychotherapy and ongoing psychiatric care.
Ready to Discuss Referring a Patient?
If you have a patient you think may be struggling despite traditional treatment approaches, we are happy to discuss whether TMS may be appropriate. Even if you are unsure whether a patient meets criteria, we welcome consultation calls.
Referral Steps
STEP 1
Direct your patient to www.riverroadtms.com or have them call River Road TMS at 804-406-4773
STEP 2
A TMS coordinator will contact them within 1-2 business days to set up a free consultation phone call
STEP 3
If appropriate, patient will be scheduled for a TMS evaluation with a River Road TMS provider and a free TMS benefits investigation will be conducted on behalf of the patient