rTMS in Quebec: options for quick access to treatment

The repetitive transcranial magnetic stimulation (rTMS) exists: it is scientifically validated and it is available in Quebec, but accessing it is not as simple as booking an appointment with a family doctor. The first decision to make is which route to take: the public system or a private clinic. These two options are not at odds: they respond to different needs and situations and many people who could benefit from this protocol simply do not know where to begin.

One figure is enough to illustrate the scale of the challenge: in 2025, only 536 patients had access to rTMS in Quebec’s public system, while the number of Quebecers living with treatment-resistant depression is estimated at 65,000. The gap speaks for itself, and it explains in large part why so many people are now turning to other options to gain faster access to this treatment. To understand what rTMS is and who it is for before addressing the question of access, our article Everything You Need to Know About rTMS is a good starting point.

The public system: covered by RAMQ, but under strain

rTMS is reimbursed by RAMQ since 2013, as part of a psychiatric prescription for refractory depression. Quebec is also among the few Canadian provinces, along with Alberta and Saskatchewan, to offer public coverage for this protocol. In these regions, rTMS can be prescribed and administered in certain hospitals or public clinics, generally for patients suffering from depression resistant to conventional treatments.

The limits, however, are very real:

• there are currently 17 rTMS devices in Quebec, concentrated in only seven health regions. The INESSS recommends adding 27 more devices, which would make it possible to treat 7,504 more people over five years.
• In the meantime, wait times vary from one week to six months depending on the region, and even in provinces where rTMS is covered, waiting lists can stretch over several months.

This situation reflects both the limited number of centers offering this solution and a growing demand for this non-invasive alternative. The Ministry of Health and Social Services has taken note of the INESSS report, but has not yet taken an official position on access to and development of rTMS in health care institutions; further analytical work will need to be done.

The public route is particularly suited to people whose treating psychiatrist practices in a region with a device, to those who can wait several weeks to a few months without immediate clinical risk, and to those who do not have private insurance. For these people, the free protocol more than makes up for the wait, especially when psychiatric follow-up continues actively during this period.

The private sector: faster, more flexible, with varying costs

The Quebec health system faces significant structural pressures, which result in delays and gaps in access to care. In this context, turning to a private clinic becomes a practical decision that many Quebecers face, not only for rTMS.

In a private clinic, access is generally without a waiting period or with a very short waiting period. Newer protocols are also available there, including Deep TMS with the H-Coil, which makes it possible to target deeper and broader brain areas than standard rTMS. At Neuroperforma, the intensive SWIFT protocol offers a condensed pace of 10 visits over 5 weeks, rather than the 36 sessions spread over 9 weeks of the standard protocol. According to data published by Hanlon and colleagues in the journal Brain Stimulation (2026), this protocol shows a response rate of 87.8% and a remission rate of 78% in the studied population, though individual results may vary and a psychiatric evaluation remains necessary to determine whether this protocol is suitable for each situation.

In terms of costs, Deep TMS with the SWIFT protocol at Neuroperforma is offered at a price of $7,960, including the psychiatric evaluation, 38 sessions, support from the clinical team and post-treatment follow-up. This protocol is not covered by RAMQ in a private clinic. Some private insurance plans, as well as certain programs for veterans or members of the Canadian Armed Forces, may cover it, in part or in full.

The private route is particularly suitable for people:

• whose treatment-resistant depression is active and for whom waiting several months would pose a clinical risk or a significant decline in quality of life,
• who live in a region not served by the public system,
• who want access to newer protocols not offered in the public system, as well as those partially covered by group or supplementary insurance.

Comparison table

	Public system	Private clinic (e.g., Neuroperforma)
Coverage	RAMQ (under conditions)	Not covered by RAMQ; private insurance possible
Access delay	1 week to 6 months depending on the region	Fast (often a few days to weeks)
Available technology	Standard rTMS	Deep TMS, SWIFT protocol
Duration	~9 weeks (36 sessions)	~5 weeks (10 visits, 38 sessions)
Supervision	Psychiatrist in the public system	Psychiatric evaluation included + dedicated team
Regional availability	7 regions out of 17 in Quebec	Clinic in Saint-Hubert (Greater Montreal)
Patient cost	$0 (RAMQ)	$7,960 (full SWIFT protocol)

What do the data say about public-private complementarity for rTMS?

The Quebec government recognizes that the public and private systems can be complementary in improving access to care, reducing waiting times and better organizing available services. In the case of rTMS, this complementarity is particularly relevant:

• the public system offers free access,
• the private sector offers speed and newer protocols.

The right choice depends on each patient’s clinical, geographic and financial situation and should always be made in consultation with a psychiatrist, as part of a shared decision-making process. The Neuroperforma article on misconceptions about rTMS can also help sort fact from fiction before making a decision.

How do you get started in practice? The two routes, step by step

Public route:

1. Consult your family doctor or treating psychiatrist.
2. Ask for an evaluation for refractory depression (criterion: failure of at least two different antidepressants).
3. Obtain a referral to a hospital center offering rTMS in your region.
4. Sign up for the waiting list and maintain psychiatric follow-up while waiting.

Private route (Neuroperforma):

1. Contact us for a free 15-minute initial assessment, with no prior diagnosis or commitment.
2. Complete the evaluation with the psychiatrist, included in the program.
3. Begin the protocol according to availability, usually quickly.
4. Benefit from integrated post-protocol follow-up.

Conclusion

Neither option is inherently better than the other: the right path is the one that matches the patient’s reality today, their region, their level of clinical risk and their financial situation. Some people even start by joining the public system’s waiting list while simultaneously exploring available private options, so as not to let time slip away needlessly. What matters is not being left without a solution for lack of information. If you are wondering which of these two routes is right for your situation, speaking with the Neuroperforma team is a good starting point.

Book your free initial assessment (15 min) →

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