Who Can
Administer TMS?

Transcranial magnetic stimulation (TMS) is a non-invasive, FDA-approved therapy that utilizes an electromagnetic field to stimulate targeted brain areas. It is used to treat major depressive disorder (MDD) or clinical depression and obsessive-compulsive disorder in patients who have not responded to traditional treatments.

Who Can
Administer TMS?

Table Of Contents

Who Is Qualified to Administer TMS?

Quick answer: A licensed physician, most often a psychiatrist, prescribes and oversees TMS therapy. The daily sessions are usually delivered by a trained TMS technician, nurse, physician assistant or nurse practitioner working under that physician’s supervision. Exactly who may run the machine depends on state rules and on the training the clinic requires.

TMS is administered by specially trained healthcare professionals, such as psychiatrists, neurologists, other physicians, physician assistants (PAs), nurse practitioners (NPs), prescribing clinical psychologists, and TMS technicians under the supervision of a medical doctor, PA, or NP. It depends on state regulations and can vary in different regions. Here is a brief overview of each specialty:

Psychiatrists

Psychiatrists are doctors who specialize in the diagnosis, treatment, and prevention of mental health disorders. After earning a medical degree, they complete four years of additional specialized training in a psychiatric residency program. This intensive education gives them in-depth knowledge of the brain and behavior, psychiatric conditions, and evidence-based treatments, such as psychotherapy, medication, and neuromodulation therapies like TMS.

Psychiatrists are licensed physicians who can prescribe drugs and administer TMS. With their comprehensive medical backgrounds, these professionals are well-equipped to evaluate patients’ symptoms, diagnose psychiatric illness, develop integrated treatment plans, and monitor progress and response to TMS.

Neurologists

Neurologists specialize in brain, spinal cord, nerve, and muscle disorders. Like psychiatrists, they attend medical school and complete a residency, but neurologists specifically focus on clinical neurology training. This gives them specialized expertise in diagnosing and treating conditions affecting the central and peripheral nervous systems. Neurologists evaluate patients using techniques like lumbar puncture, EEG, and imaging tests. They can order and interpret these advanced tests to identify potential contributors to an individual’s symptoms.

With their specialized knowledge, neurologists determine if TMS is appropriate for conditions like Parkinson’s disease, epilepsy, stroke, headaches, and pain. Their medical training also allows them to prescribe medication and administer TMS therapy.

Other Physicians

Physicians from other specialties beyond neurology and psychiatry can obtain credentials to provide TMS. This therapy requires specialized equipment and training, so oversight by a licensed medical doctor is necessary. Physicians interested in adopting TMS into their clinical practice must complete an accredited training course on safely and effectively using the equipment and coils. They also need to receive instruction on proper patient selection, targeting treatment areas of the brain, and monitoring patient response. With this supplemental training, physicians can incorporate TMS as an additional procedure for the interventions already available in their specialty.

Physician Assistants

Physician assistants (PAs) are licensed professionals who practice medicine under physician supervision. They attend an accredited PA program, usually 2-3 years beyond a bachelor’s degree, and pass a national certifying exam. Working closely with doctors, PAs can conduct patient exams, order tests, make diagnoses, and provide treatments.

With proper training and supervision by a qualified physician, PAs may help manage TMS therapy sessions. They can monitor patient progress, adjust equipment settings, and communicate results to the overseeing doctor. PAs increase the availability of TMS, while physician oversight provides the necessary medical guidance.

Nurse Practitioners

Nurse practitioners (NPs) are registered nurses who earn an advanced nursing degree and national certification. In most states, NPs can assess patients, order tests, make diagnoses, and prescribe medication. Working in collaboration with physicians, NPs help expand access to TMS therapy under medical supervision.

With their comprehensive nursing knowledge and advanced education, NPs are well-prepared to oversee the TMS process. An NP can meet with patients, operate equipment, monitor progress, report to the collaborating physician, and coordinate care with other providers. They increase the availability of this beneficial neuromodulation treatment.

Prescribing Clinical Psychologists

In certain states with specific regulations, licensed clinical psychologists may expand their scope of practice to offer more advanced types of therapy. With additional training, these professionals can prescribe psychotropic medications for conditions they treat, including depression, anxiety, and obsessive-compulsive disorder. In the same way, clinical psychologists may be licensed to deliver TMS. They can provide integrated care by combining TMS with psychotherapy and medication management. Their behavioral health expertise allows them to identify appropriate patients, support them throughout treatment, and monitor TMS results.

Overall, all therapists must know the safety protocols necessary to operate the equipment and the effects of TMS on different brain areas. Participation in professional organizations, such as the American Academy of Neurology or the American Medical Association, can provide an additional quality marker for specialists to receive TMS certification.

Types of TMS Certifications

TMS Technician

The TMS technician certification indicates specialized skills and knowledge in transcranial magnetic stimulation technology. Such specialists are trained in the safe and effective operation of TMS equipment. They understand the physics and biological effects of this technology. Technicians can administer TMS therapy under the supervision of a practitioner and assist with tasks like preparing patients, operating the equipment, and monitoring patient tolerance. They play an essential role in delivering TMS treatment safely and effectively.

TMS Practitioner

The TMS practitioner certification represents expert-level competency in transcranial magnetic stimulation. Such specialists have extensive knowledge of TMS technology, physics, and biological effects. They have the clinical skills to independently oversee TMS therapy, including assessing patients, developing treatment plans, calibrating equipment, administering procedures, and monitoring outcomes. TMS practitioners understand how to apply this innovative approach in psychiatry, neurology, or rehabilitation medicine.

Requirements for Certification and Maintaining Certification

To become certified in administering TMS treatments, clinicians must complete a training course from an accredited provider, such as Solstice Training Institute. The curriculum includes the theoretical and practical aspects of TMS therapy, such as the physics of magnetic stimulation, specific treatment protocols, neurophysiology, and other crucial knowledge. Clinicians must also meet the professional and educational requirements (e.g., a bachelor’s degree is a health-related field) to enroll in accredited training programs.

To maintain TMS technician certification, clinicians must participate in continuous education. Training courses cover the latest advancements in TMS therapy, safety precautions, and patient setup. Additionally, clinicians must participate in hands-on sessions to use new treatment protocols and equipment.

How to Become a TMS Technician

A TMS technician is the person most patients see at their daily sessions. After the physician sets the treatment plan, the technician seats the patient, places the coil in the mapped position, runs the session and records how the patient is doing. In most states there is no separate government license for TMS technicians, so the supervising physician and the clinic’s own training standards decide who may deliver treatment.

The Typical Path to TMS Technician Certification

A healthcare background. Many technicians come from medical assistant, nursing, psychiatric technician or psychology roles, and clinics usually ask for current CPR or Basic Life Support certification.
Device training. The maker of the clinic’s TMS system trains staff on that machine, its coil and its treatment protocols. Learn more about the different TMS devices.
A technician course. Training providers such as Solstice Training Institute offer TMS technician courses on safety, coil placement and protocols that end in a certificate.
Supervised practice. New technicians deliver treatments under an experienced clinician before working on their own, then keep up with continuing education as protocols change.

Who Prescribes TMS and Who Delivers It?

A licensed physician, usually a psychiatrist, evaluates the patient, confirms that TMS is appropriate, finds the motor threshold that sets the treatment strength and writes the plan. TMS devices are labeled for use under a physician’s supervision, so the doctor stays responsible for the whole course and is available if a problem comes up, while a trained technician delivers the day-to-day sessions. In some states, nurse practitioners and physician assistants take on parts of the physician’s role.

FDA-cleared uses now include major depression, obsessive-compulsive disorder, smoking cessation and anxiety symptoms that come with depression, and in 2024 one system was cleared for depression in teens aged 15 and older. Not sure if TMS fits you? Read who is a candidate for TMS therapy.

Questions to Ask a TMS Clinic

Who is the supervising physician, and are they on site during sessions?
Who will deliver my daily sessions, and what training and certification do they have?
Which TMS device and protocol will you use for my condition?
Will my plan cover treatment? Our TMS insurance guide explains what most insurers ask for.
What will a typical session be like? See what to expect during TMS.

You can compare clinics and their providers in our TMS clinic directory or search for TMS clinics near you.

FAQs Regarding TMS Administration

Is TMS a Noninvasive Treatment Option?

TMS is a noninvasive treatment option for certain neurological and psychiatric disorders. It involves sending a magnetic pulse, generated by a coil placed over the scalp, into parts of the brain associated with the condition being treated. The magnetic energy stimulates nerve cells, leading to beneficial changes in an individual’s neural activity.

What Mental Health Conditions Can Be Treated With TMS?

Repetitive transcranial magnetic stimulation is used to treat several mental health conditions. It is currently FDA-approved for major depression and obsessive-compulsive disorder. Additionally, deep transcranial magnetic stimulation has been used to effectively treat other diseases in clinical trials, including post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), attention deficit hyperactivity disorder (ADHD), and bipolar disorder. Research is ongoing to explore the effectiveness of deep TMS for these and other mental health conditions.

Is TMS a Noninvasive Treatment Option?

What Mental Health Conditions Can Be Treated With TMS?

Does Transcranial Magnetic
Stimulation Have Side Effects?

Yes, TMS magnetic stimulation can have side effects. These adverse reactions may include headaches, lightheadedness, scalp discomfort, and muscle twitching. In some cases, patients experience fatigue, a feeling of tingling or pins and needles in the extremities, and mild to moderate scalp irritation after treatment sessions. These side effects are generally considered minor compared to electroconvulsive therapy and other invasive treatments. However, it is essential to discuss any concerns with your healthcare provider. People with certain medical conditions, such as epilepsy, should consult a doctor before receiving deep brain stimulation to ensure that it is safe for them to undergo this type of non-invasive treatment.

What Is Involved in a TMS
Therapy Session?

A TMS treatment session typically takes about 20-45 minutes, during which the patient is seated in a comfortable chair. The clinician places the coil on the scalp directly above the area of the brain to address symptoms associated with depression or OCD. During treatment, pulses of magnetic energy are slowly passed through the coil and penetrate just below the surface of the skull. The pulses stimulate neurons in the targeted area of the brain, helping to reduce symptoms associated with depression or OCD.

TMS can address mental health conditions that have been resistant to antidepressant medications. This therapy is administered by certified medical professionals with appropriate training and qualifications. TMS has been proven safe, well tolerated, and relatively free of side effects.