How much does ECT cost? 2026 Medicare amounts, insurance, and what a full course adds up to

Three bills per treatment

What Medicare pays for one ECT treatment in New Jersey in 2026

ECT is not priced as one item. The psychiatrist, the anesthesia team, and the hospital each bill for every treatment, and Medicare publishes an amount for each.

Medicare splits New Jersey into two payment areas. “Northern NJ” is Bergen, Essex, Hudson, Hunterdon, Middlesex, Morris, Passaic, Somerset, Sussex, Union, and Warren counties; every other county is “rest of New Jersey.” The amounts above are CMS's 2026 figures for clinicians who are not in a qualifying alternative payment model; qualifying participants are paid slightly more, because CMS uses a higher conversion factor for them ($33.5675 instead of $33.4009).

Anesthesia is paid by the minute. CMS counts 4 base units for anesthesia for ECT and adds one time unit for every 15 minutes the anesthesia clinician is with the patient, from preparing for anesthesia until the patient can safely be handed to recovery staff. The 15-minute figure used on this page is a worked example, not a typical time; your anesthesia bill will show the minutes actually recorded.

A full course

What 6, 12, or a year of maintenance treatments adds up to

Cost follows the number of treatments. Mayo Clinic says ECT in the U.S. is generally given 2 to 3 times a week for 3 to 4 weeks, 6 to 12 treatments in all.

Each row is $105.92 for the psychiatrist, $110.45 for anesthesia with 15 minutes recorded, and $877.34 for the hospital, times the number of treatments. The share column uses 20 percent of the psychiatrist and anesthesia amounts and the $175.47 national unadjusted hospital copayment for this service, and assumes the $283 Part B deductible is already met; if it is not, the deductible adds up to $226.40 to the first treatment's share.

Programs describe the number of treatments in similar terms. Northwell's ECT program gives treatment once every two to five days, for 6 to 12 sessions in a typical acute course. Weill Cornell says patients treated for depression normally need 8 to 10, two or three times a week. Aetna's policy says more than 20 sessions in one series is rarely medically necessary, and that maintenance sessions often start weekly and are spaced out to every two weeks, monthly, or less. The 2018 JAMA Psychiatry cost study cites 10 to 20 maintenance treatments a year.

With Original Medicare

Outpatient ECT is Part B. A hospital stay is Part A.

Where you get ECT decides which part of Medicare pays the hospital, and that changes your share more than any single treatment price.

• Outpatient ECT (Part B). You pay the $283 Part B deductible once in 2026, then usually 20 percent of the psychiatrist's and the anesthesia amounts, plus a copayment to the hospital for each treatment. Medicare.gov says the hospital copayment in most cases won't be more than the Part A hospital stay deductible.
• Inpatient ECT (Part A for the hospital). The $1,736 Part A deductible covers days 1 to 60 of a benefit period. Days 61 to 90 cost $434 a day, and lifetime reserve days $868 a day. You also pay 20 percent of the approved amount for the psychiatrist and anesthesia services you get as an inpatient: at the northern New Jersey amounts above, about $43.27 a treatment.
• Psychiatric hospitals. Part A pays for up to 190 days of inpatient care in a psychiatric hospital over your lifetime. Care in a general hospital's psychiatric unit does not count toward that limit.
• Multiple-seizure ECT is not covered. Medicare's national coverage rule 160.25 says multiple-seizure ECT (MECT), where more than one seizure is induced in a session, is not reasonable and necessary and is not covered.
• Supplemental coverage. Original Medicare has no yearly out-of-pocket limit. A Medigap policy or a Medicare Advantage plan changes what you pay; ask the plan for its ECT cost-sharing in writing.

With private insurance

Check medical necessity, prior authorization, and all three networks.

A commercial plan applies its deductible, copay or coinsurance, and out-of-pocket maximum to every bill in every treatment. The plan's ECT policy decides whether it pays at all.

Aetna's published policy is a clear example. It considers ECT medically necessary for major depressive disorder, bipolar disorder, mania, catatonia, and some other conditions, for members age 12 or older who meet one of six criteria. These include not responding to or not tolerating effective medications, a good response to ECT in the past, being unable to safely wait for medication to work, severe depression or mania during pregnancy, or preferring ECT after talking with the psychiatrist. The same policy lists multiple monitored ECT and ultrabrief bilateral ECT as experimental, and it covers both 90870 and the anesthesia code 00104 when the criteria are met.

Ask your plan three questions before the first treatment: does ECT need prior authorization, how many treatments does an approval cover, and are the hospital, the psychiatrist, and the anesthesia group all in network? Anesthesia is billed under its own code, and the anesthesia clinician can bill separately from the hospital, so a hospital being in network does not settle the anesthesia bill.

With NJ FamilyCare (Medicaid)

Coverage runs through your managed care plan, with prior authorization.

NJ FamilyCare's covered services include inpatient and outpatient hospital treatment, behavioral health, and inpatient psychiatric care. Most members get those services through one of the program's managed care plans.

The state lists the managed care plans under contract, including Aetna Better Health of New Jersey, Fidelis Care, and Horizon NJ Health, with the counties each serves. Horizon NJ Health, for example, lists electroconvulsive therapy among the behavioral health services that need prior authorization from both in-network and out-of-network providers. Call the member services number on your plan card to ask how ECT is approved and which hospitals are in network.

Without insurance

Self-pay prices vary. Get a written estimate from each provider.

No national self-pay price for ECT exists. Published figures range widely, and most online numbers trace back to a few sources.

• A marketplace price. MDsave, a site that sells prepaid procedures, lists ECT at four Ohio Mercy Health hospitals for $1,599 per treatment and gives an estimated national average of $3,330. Those listings are not in New Jersey, and the pages we read do not itemize what the price includes.
• The often-quoted range. The 2018 JAMA Psychiatry cost study states that ECT has been estimated at $300 to $1,000 per treatment, citing earlier sources, and that 5 to 15 treatments per initial course plus 10 to 20 maintenance treatments a year can push the annual cost past $10,000.
• Your right to an estimate. Under the No Surprises Act, providers usually must give self-pay patients a written good faith estimate when care is scheduled at least 3 business days ahead, or when asked. Each estimate covers one provider or facility, so ask the hospital, the psychiatrist, and the anesthesia group separately. If a bill is at least $400 more than that provider's estimate, you can dispute it within 120 days of the first bill.
• Hospital price lists. Since January 1, 2021, hospitals must post their standard charges, including the discounted cash price, and list at least 300 shoppable services in a consumer-friendly display.

ECT, TMS, and SPRAVATO

How a course of ECT compares with TMS and SPRAVATO® on cost

At Medicare's 2026 amounts, a first course of each treatment lands in a similar range. The schedules, settings, and side effects differ far more than the price.

The TMS and SPRAVATO figures come from our TMS cost guide and SPRAVATO cost guide, which use the same 2026 Medicare files. ECT is given under general anesthesia in a medical setting, TMS in an office while awake, and SPRAVATO in a certified office with a two-hour observation. Our ECT and TMS comparison covers how the two differ beyond cost.

Costs outside the three bills

The evaluation, the rides, and the time off work

Budget for the visits before the first treatment and for someone to drive you home after each one.

• The evaluation. Mayo Clinic says the work-up before a first ECT treatment usually includes a medical history, a physical exam, a mental health assessment, basic blood tests, an ECG, and a discussion of anesthesia risks. Each can be billed under your plan's normal rules.
• A companion. Northwell's program says patients must be accompanied by a responsible adult who stays on campus during treatment and recovery. Weill Cornell says the whole visit takes about 75 minutes.
• Driving and work. Mayo Clinic says your care team may advise you not to drive, return to work, or make important decisions until one to two weeks after the last treatment in a series, or for at least 24 hours after a single maintenance treatment.

Is it worth the cost?

What the cost research found

The best-known U.S. study found ECT cost-effective when offered as the third treatment for depression that has not responded to two others.

The 2018 JAMA Psychiatry study by Ross, Zivin, and Maixner modeled depression care over four years. Offering ECT as a third-line treatment cost an estimated $54,000 per quality-adjusted life-year gained, below the $100,000 threshold the authors used, and cut time with uncontrolled depression from 50 percent to 34 percent of life-years. The paper cites research in which 50 to 60 percent of patients reached rapid remission after a course of ECT, compared with 10 to 40 percent with medication or psychotherapy. Memory effects belong in the same conversation: our ECT memory guide and life after ECT guide cover what to ask.