Known For: Solo psychiatrist Dr. Rajan Gosain trained at Harvard South Shore and Tufts Medical Center, operating BrainsWay Deep TMS — one of the few devices with standalone FDA clearance for OCD — alongside Clinical TMS Society and OCD Foundation memberships and a VA Special Contribution Award.
Location
Sacramento, California
Address
10419 Old Placerville Road, Suite 252 Sacramento, CA 95827 United States
Most major commercial plans, Medicare Part B, and Tricare typically cover TMS for treatment-resistant depression after prior authorization — verify with this clinic.
HealingMaps Take: A TMS-focused practice in Sacramento, CA for treatment-resistant depression and FDA-cleared adjacent indications. Verify the specific device, available protocols, and prior-authorization handling on your consult call.
Market Position: Standard transcranial magnetic stimulation is offered at this Sacramento, CA location for treatment-resistant depression as covered by most major insurance plans after prior authorization.
Is Rajan Gosain MD Right for You?
✓ Choose Rajan Gosain MD if:
You’re seeking FDA-cleared TMS for treatment-resistant depression in Sacramento
You’re being treated for OCD — verify with the clinic which device they operate (only BrainsWay Deep TMS holds standalone FDA OCD clearance)
✗ Look elsewhere if:
You need accelerated SAINT-style TMS (5-day course) — ask the clinic to confirm whether they’re Magnus-credentialed
You want the 3-minute iTBS protocol specifically — this clinic may run only standard rTMS
You need rapid relief within days — TMS takes 2–4 weeks to start working. Consider ketamine or Spravato for acute stabilization
TMS protocols at this clinic
This clinic offers standard 10 Hz rTMS (19–37 minutes per session), the most common TMS protocol and FDA-cleared for treatment-resistant depression, anxious depression, and adolescent MDD (ages 15–21). For Deep TMS, iTBS (3-min), or accelerated SAINT-style protocols, ask the clinic directly during your consult call. See our complete TMS therapy guide for a full device and protocol comparison.
What to expect at your first appointment
Insurance pre-authorization (1–3 weeks). Before treatment begins, the clinic submits a prior-authorization request to your insurer. The request typically requires: a confirmed DSM-5 major depressive disorder diagnosis from a psychiatrist, documented failure of 2 to 4 adequate antidepressant trials (most carriers require at least 6 weeks at therapeutic dose for each), a baseline depression rating scale (PHQ-9, HAM-D, or BDI), and evidence of inadequate response to or contraindication for psychotherapy. About 30–50% of initial requests are denied; the highest-yield appeal is a peer-to-peer review between the clinic’s psychiatrist and the insurer’s medical reviewer (success rate exceeds 60% with full prior-trial documentation).
Motor threshold mapping (first session, 30–60 minutes added). The clinician delivers single magnetic pulses to the motor cortex and finds the minimum stimulation intensity that elicits a thumb or finger twitch. This motor threshold value sets dosing for every subsequent session — typically 110 to 120 percent of motor threshold. Re-mapping is non-routine.
Daily treatment sessions (5x/week, 19–37 min each for standard rTMS or 3 min for iTBS). You sit in a recliner with hearing protection (the magnetic pulses are loud). The coil is positioned against the scalp; you feel a tapping sensation during stimulation. There is no medication, no IV, no need to fast. Patients commonly read, listen to music, or scroll their phone during the session.
Drive home, return to work. No anesthesia means you drive yourself to and from each session. You return to work, school, or your normal day immediately afterward — no chaperone, no recovery period, no integration block. Many patients schedule sessions during a lunch break.
Questions to ask on your consult call
Which TMS device do you operate? NeuroStar, BrainsWay, MagVenture, Magstim, or Nexstim — the answer determines what conditions can be treated on-label. For OCD, only BrainsWay Deep TMS H7 has standalone FDA clearance. For adolescents (15–21), only NeuroStar (since 2024) and BrainsWay (since 2025) hold the relevant clearances.
Which protocols are available? Standard 10 Hz rTMS is universal. Ask about iTBS (3-minute sessions, FDA-cleared 2018), Deep TMS (BrainsWay H-coil, FDA-cleared 2013–2025 across multiple indications), and accelerated TMS — particularly SAINT (Magnus-credentialed Stanford protocol, 50 sessions in 5 days, $19,703 CMS hospital reimbursement effective July 2025).
Do you handle prior authorization in-house? Ask about the clinic’s peer-to-peer review process and what their success rate is when the initial PA is denied.
Are you in-network with my insurer? Verify network status with BCBS, Aetna, Cigna, UnitedHealthcare, Anthem, Humana, Medicare Part B, or Tricare — and ask about cash-pay package discounts (typically 10–25% off rack rate).
What does maintenance look like after the acute course? Ask about tapering boosters (weekly × 3 → biweekly × 3 → monthly), PRN booster sessions for early symptom return, and whether they recommend continued antidepressant maintenance during and after TMS.
Frequently asked questions
How much does TMS cost at this clinic?
Cash-pay TMS sessions in Sacramento, CA typically run $300 to $500 per session, with the full 36-session course costing $7,200 to $15,000. Premium-metro clinics (NYC, San Francisco, Los Angeles, Boston) charge 30 to 50 percent more. With insurance, copays typically run $0 to $250 per session depending on your deductible status; most patients with employer-sponsored PPO plans pay $500 to $3,000 out-of-pocket for a full course. Many independent clinics offer 10 to 25 percent package discounts for cash-pay patients. TMS is HSA- and FSA-eligible. Contact this clinic directly for their specific cash-pay rates and in-network status with your insurer.
Does insurance cover TMS at this clinic?
Most major commercial insurance plans (BCBS, Aetna, Cigna, UnitedHealthcare, Anthem, Humana), Medicare Part B, and Tricare cover TMS for treatment-resistant major depressive disorder. UnitedHealthcare typically requires 3 failed antidepressant trials; most other carriers require 2. Pre-authorization is mandatory across all major carriers. Coverage for off-label conditions (PTSD, fibromyalgia, bipolar depression, migraine) is rarely approved. Contact this clinic to verify in-network status with your specific insurer and to learn about their prior-authorization handling.
What is the “TMS dip” and will I experience it at this clinic?
The “TMS dip” is a patient-coined term for temporary worsening of mood or symptom intensification that some patients experience roughly mid-course (commonly between sessions 10 and 20) before clinical improvement begins. It’s not a sign that TMS is failing — it usually resolves with continued treatment. If you experience the dip, tell your clinician immediately. They may adjust intensity, frequency, or coil position. Importantly, dropping out before session 20 substantially reduces overall response rate. Patients who push through the mid-course dip generally have better outcomes than those who quit early.
Can I drive myself to and from sessions? Can I work the same day?
Yes. TMS requires no anesthesia, no sedation, and no IV access. Patients drive themselves to sessions, return to work, school, or normal activities immediately afterward, and need no chaperone or recovery period. This is the single largest patient-experience advantage TMS holds over ketamine therapy and ECT. Many patients schedule sessions on lunch breaks. The only post-session sensation is mild scalp tenderness for the first few sessions, which decreases substantially as scalp nerves desensitize.
Which TMS device does this clinic use, and why does it matter?
Devices vary across TMS clinics — common options include NeuroStar (figure-8 coil, market leader), BrainsWay Deep TMS (H-coil family, only standalone FDA OCD clearance), MagVenture (Cool-B65, supports the 3-min iTBS protocol marketed as Express TMS), Magstim (Horizon with StimGuide navigation), and Nexstim (MRI-guided NBT). The device determines what conditions can be treated on-label. For OCD, only BrainsWay Deep TMS H7 has a standalone FDA clearance. For adolescents 15–21, only NeuroStar (since March 2024) and BrainsWay (since November 2025) hold the relevant indications. Ask the clinic which device they operate before booking.
Does this clinic treat OCD with TMS?
Possibly — but only BrainsWay Deep TMS using the H7 coil holds a standalone FDA clearance for OCD (granted via the De Novo pathway in 2018). MagVenture’s Cool D-B80 has an OCD adjunct clearance. Standard NeuroStar (figure-8 coil) is not FDA-cleared for OCD. Confirm with this clinic specifically which device they use for OCD treatment. The full OCD course is 29 sessions over 6 weeks with symptom-provocation protocols.
Rajan Gosain MD provides transcranial magnetic stimulation (TMS) therapy for patients battling treatment-resistant disorders. The private practice, led by Dr. Rajan Gosain, aims to help people find healing where traditional medicine has failed. TMS therapy is relatively new but clinically proven to help improve the symptoms of depression, OCD, anxiety, and other mood disorders.
Interested in joining a Psychedelics Clinical Trial? Sign up here nowand we will connect you with a clinical trial in your area when one becomes available.
Dr. Rajan Gosain founded Rajan Gosain MD in the hopes of utilizing his skills and knowledge in the medical field to make the world’s of his patients a little brighter. He has completed advanced training in TMS and is also part of the clinical TMS society. Along with his practice, Dr. Gosain has also led many clinical teams in learning and administering TMS therapy.
Angelica Bottaro is a medical writer and researcher with a rich background in psychology and journalism. She holds a bachelor's degree in Psychology from Trent University and an Advanced Diploma in Journalism from Centennial College. Angelica has been a freelance writer since 2014, amassing bylines in various platforms like Very Well Health, The Good Men Project, MakeWell, and LymeTime among others. Although primarily a freelance writer, her educational background and career trajectory have positioned her as a voice in mental health discourse, highlighting systemic issues in mental health care through her writing.
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