H 152

GENERAL ASSEMBLY OF NORTH CAROLINA
  SESSION 2025
 H  1
  HOUSE BILL 152
 Short Title:   Access to Transcranial Magnetic Stimulation.  (Public)
 Sponsors:      Representatives Huneycutt, Lambeth, Potts, and Reeder (Primary Sponsors).
  For a complete list of sponsors, refer to the North Carolina General Assembly web site.
 Referred to:   Health, if favorable, Insurance, if favorable, Rules, Calendar, and Operations of
  the House
  February 21, 2025
1A BILL TO BE ENTITLED
2 AN ACT TO PROVIDE FAIR REIMBURSEMENT OF TRANSCRANIAL MAGNETIC
3     STIMULATION SERVICES UNDER HEALTH BENEFIT PLANS OFFERED IN THIS
4     STATE.
5 The General Assembly of North Carolina enacts:
6SECTION 1.(a) Article 3 of Chapter 58 of the General Statutes is amended by adding
7 a new section to read:
8 "§ 58-3-254. Coverage of transcranial magnetic stimulation.
9     (a)     The following definitions apply in this section:
10(1)     Reserved for future codification purposes.
11(2)     Insurer. – As defined in G.S. 58-3-167.
12(3)     Reserved for future codification purposes.
13(4)     Transcranial magnetic stimulation. – A noninvasive healthcare treatment that
14uses pulsed magnetic fields to induce an electric current in a localized region
15of a patient's brain.
16     (b)     Insurers offering a health benefit plan in this State that provides coverage for
17 transcranial magnetic stimulation shall provide coverage for all transcranial magnetic stimulation
18 procedures performed by a healthcare facility or properly licensed healthcare provider for whom
19 ordering, performing, and supervising the treatment of depression and other mental disorders is
20 within their scope of practice in accordance with Chapter 90 of the General Statutes and may not
21 penalize any properly licensed healthcare provider or healthcare facility that properly submits a
22 claim for services related to transcranial magnetic stimulation based on the medical specialty of
23 the healthcare provider or healthcare facility submitting the claim.
24     (c)     Notwithstanding subsection (b) of this section, it shall be within the discretion of each
25 insurer offering a health benefit plan in the State that provides coverage for transcranial magnetic
26 stimulation to determine all of the following aspects of the coverage:
27(1)     Whether to cover transcranial magnetic stimulation procedures.
28(2)     Indications for which transcranial magnetic stimulation procedures shall be
29covered.
30(3)     Requirements for coverage for transcranial magnetic stimulation procedures.
31(4)     Reimbursement rates for transcranial magnetic stimulation procedures.
32     (d)     Penalties prohibited under this section include the denial of, or the reduction of, or
33 the placement of limitations on the reimbursement of a properly submitted claim, or any other
34 negative treatment of a properly submitted claim.
  *H152-v-1*
 General Assembly Of North Carolina  Session 2025
1     (e)     Reimbursement rates that differ based upon any of the following are allowable and
2 shall not be considered a penalty prohibited under this section:
3(1)    A healthcare provider's participation or lack of participation in the network of
4an insurer.
5(2)    The location where the transcranial magnetic stimulation services are
6provided.
7(3)    The level of training, certification, or education of the healthcare provider,
8within that provider's medical specialty, that has provided the transcranial
9magnetic stimulation services."
10SECTION 1.(b) G.S. 135-48.51 is amended by adding a new subdivision to read:
11"(8a) G.S. 58-3-254, Coverage of transcranial magnetic stimulation. It is within the
12discretion of the Plan to determine all aspects of the coverage of transcranial
13magnetic stimulation identified under G.S. 58-3-254(b)."
14SECTION 2. This act is effective October 1, 2025, and applies to insurance contracts
15 issued, renewed, or amended on or after that date.
 Page 2  House Bill 152-First Edition