ACCESS TO TRANSCRANIAL MAGNETIC STIMULATION.

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View NCGA Bill Details2023-2024 Session
House Bill 939 (Public) Filed Tuesday, April 30, 2024
AN ACT TO PROVIDE FAIR REIMBURSEMENT OF TRANSCRANIAL MAGNETIC STIMULATION SERVICES UNDER HEALTH BENEFIT PLANS OFFERED IN THIS STATE.
Intro. by Sasser, Potts, Crutchfield.

Status: Re-ref Com On Appropriations (House action) (Jun 11 2024)
H 939

Bill Summaries:

  • Summary date: Jun 11 2024 - View Summary

    House committee substitute to the 1st edition makes the following changes.

    Amends proposed new GS 58-3-254 as follows. Requires that the coverage for transcranial magnetic stimulation be for those procedures preformed by a healthcare facility or properly licensed healthcare provider for whom ordering, performing, and supervising the treatment of depression and other mental disorders is within their scope of practice (was, by any properly licensed healthcare provider or healthcare facility). Adds that it is within the discretion of each insurer offering a health benefit plan in the State that provides coverage for transcranial magnetic stimulation and the State Health Plan to determine: (1) whether to cover transcranial magnetic stimulation procedures, (2) indications for which transcranial magnetic stimulation procedures must be covered, (3) requirements for coverage for transcranial magnetic stimulation procedures, and (4) reimbursement rates for transcranial magnetic stimulation procedures. Also adds that reimbursement rates that differ based on the following are allowed and not considered to be a prohibited penalty: (1) a healthcare provider's participation or lack of participation in an insurer's network; (2) the location where the transcranial magnetic stimulation services are provided; or (3) the level of training, certification, or education of the healthcare provider, within that provider's medical specialty, that has provided the transcranial magnetic stimulation services.


  • Summary date: Apr 30 2024 - View Summary

    Enacts new GS 58-3-254 requiring insurers offering a health benefit plan in North Carolina that provides coverage for transcranial magnetic stimulation (as defined) to provide coverage for those procedures performed by any properly licensed healthcare provider or healthcare facility and prohibits penalizing any licensed provider or facility that properly submits a claim for services related to transcranial magnetic stimulation based on the medical specialty of the provider or facility submitting the claim. Includes a list of penalties prohibited under this statute. Amends GS 135-48.51 by making new GS 58-3-254 applicable to the State Health Plan. Applies to insurance contracts issued, renewed, or amended on or after October 1, 2024.

    Appropriates $1 million in recurring funds for 2024-25 from the General Fund to the Department of State Treasurer to ensure compliance with this act by the State Health Plan. Effective July 1, 2024.