Electroconvulsive Therapy (ECT)

ECT Treatment | ECT FAQ | ECT Billing | ECT Resources |
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What Is Electroconvulsive Therapy or ECT?

Most patients treated with antidepressants for depression do well. Unfortunately, there is a significant number of people who will either fail to respond, or who will have only a temporary or partial response to the antidepressants. Electroconvulsive therapy, or ECT, has been an effective brain stimulation treatment for many people with treatment-resistant mood disorders including:

• Major depressive disorder (MDD)
• Bipolar disorder
• Catatonia
• Schizophrenia

How Does MUSC Health Use ECT?

At MUSC Health, our mental health experts have access to the latest equipment, and are using the most effective evidence-based treatments. This not only improves success rates; but these treatments reduce some of the undesirable side effects associated with classic electroconvulsive therapies, such as short-term memory loss or headaches.  

Modern ECT has advanced so that your treatment is safe and well tolerated. You will be under anesthesia, and a muscle relaxant called succinylcholine is administered to completely relax your muscles. Soft electrode patches are placed on your face and temple. At MUSC Health, our advanced ECT finds the specific brain dose for each person and applies it in a briefer time to more focused areas of the brain involved with your mental health condition. The treatment lasts only a few minutes, then you will be awakened and are generally able to go home within an hour.

Patients typically receive about ten treatments spaced out over a period of three to four weeks. Some patients return for maintenance treatments. These might be one per week, or one per month, or as infrequent as once per year.

All patients respond differently. On average between 70-90% of ECT patients respond with improvements from severe depression, with 50-70% of patients no longer having a major depressive episode. 

We continue with clinical research treatment studies to refine further and improve the treatments for the future. Please reach out if you are interested in participating or let us know in consultation.

Billing and Insurance for ECT

As a patient at the MUSC Health Department of Psychiatry, Brain Stimulation Division, you will receive bills from the physicians and from the hospital. MUSC Physicians (MUSCP) submits bills for the professional fees charged by its physicians. The Medical University Hospital Associate (MUHA) bills for hospital facility charges for the use of equipment, space, and supplies. Both MUSC entities participate with Medicare, BlueCross BlueShield, and various other payers and managed care organizations. They do not, however, participate with all payers. Regulations also require us to bill for deductibles and co-payments, even for those insurances with which we participate. Co-payments will be required before or at the time of service.

MUHA may participate with a health plan, but MUSCP may not. In this instance, you would be responsible for paying for the portion of your physician’s bill that your insurance plan does not cover. Depending upon your insurance, you may not receive a bill at all, but instead receive an explanation of benefits, which will outline what your insurance was charged and what was paid on your behalf.

In some instances, your insurance requires a prior authorization before you begin treatment. Without the prior authorization, you will be required to pay for all bills. Some insurers do not require a prior authorization, but whether an authorization is required, it’s still not a guarantee of payment. All payments are based on medical necessity and cannot be determined until the claim is processed. The medical documentation will be reviewed in order for the insurance company to determine payment. Thus there is no guarantee how much is covered and if insurance does not cover the charges, then the patient is responsible for payment.

Some people choose to pay out of pocket for procedures, either because insurance is not covering treatment or because patients do not want to use insurance. Most patients paying out of pocket for ECT are eligible for 50% discount in total charges. Nevertheless, an ECT series is still generally expensive to pay out of pocket. You may request contact with Shayna Epstein at 843-792-1879, the Brain Stimulation Service hospital business manager, for questions about out of pocket costs for ECT. 

ECT Patient Forms and Resources

Forms

• ECT General Consent Form (PDF)

Additional Resources

• TED Talk on ECT by surgeon and author Sherwin Nuland
• International Society for ECT and Neurostimulation: patient stories
• You may also be interested in a book by Kitty Dukakis titled Shock.