Why This Comparison Matters
NeuroStar and BrainsWay Deep TMS sit in the same tms devices category but take different approaches. NeuroStar (Neuronetics) uses Transcranial Magnetic Stimulation (focused figure-8 coil) while BrainsWay Deep TMS (BrainsWay) uses Deep TMS (H-Coil Technology) for deeper brain stimulation. Both received FDA clearance (2008 and 2013 respectively) and both are actively sold in the US market. The decision between them is rarely about which is objectively better. It's about which fits your specific practice.
Physicians end up comparing these two devices when they're shopping in the $80,000-$150,000 to $100,000-$200,000 price range and want a category leader. Both devices are commonly recommended by sales reps from competing manufacturers, which means physicians often hear inflated claims about one and dismissive claims about the other. This comparison strips out the marketing and looks at pricing, mechanism, evidence, and practice fit side by side.
The Verdict
Choose NeuroStar if your practice prioritizes Neuronetics's ecosystem, brand recognition, or specific clinical advantages. Psychiatrists starting a TMS practice who want the most established platform with the strongest insurance reimbursement track record. Practices that value the largest clinical dataset. The pros that matter most: First-mover advantage: largest installed base in the US; 5M+ treatments delivered (largest outcomes registry). The biggest tradeoff to accept: Standard TMS depth (~2cm) vs BrainsWay's deep TMS (~6cm).
Choose BrainsWay Deep TMS if BrainsWay's positioning fits better. Psychiatrists who want the deepest stimulation available and value the expanded indication set (OCD, smoking cessation). Practices serving treatment-resistant patients where standard TMS depth may be insufficient. The pros that matter most: Deepest brain stimulation in TMS category (6cm with H-coil); FDA-cleared for 3 indications (depression, OCD, smoking cessation). The biggest tradeoff to accept: Higher upfront cost than NeuroStar.
For a practice with limited capital that needs maximum flexibility, used pricing tilts the math. NeuroStar used units run $40,000-$80,000; BrainsWay Deep TMS used units run $50,000-$120,000. For practices with strong patient flow already, the device that integrates with your existing platforms is usually the right answer even if its standalone specs are slightly weaker. For practices building a category from scratch, brand recognition and patient demand matter more than raw clinical specs. Look at which device patients are already asking for in your market before signing a contract.
Depth of Stimulation: Why It Matters
The defining technical difference between NeuroStar and BrainsWay is penetration depth. NeuroStar's figure-8 coil reaches approximately 2cm below the skull surface, targeting the dorsolateral prefrontal cortex (DLPFC). BrainsWay's patented H-coil reaches approximately 6cm, stimulating deeper and broader brain regions.
Deeper stimulation matters because depression involves circuits that extend beyond the cortical surface. BrainsWay's clinical data for OCD, which requires stimulation of deeper structures (anterior cingulate cortex), drove their additional FDA clearances. For standard major depressive disorder, both systems show comparable efficacy in randomized controlled trials. The depth advantage becomes more relevant for treatment-resistant patients who have failed standard TMS protocols.
Practical implication for your practice: if you treat mostly straightforward MDD referrals, NeuroStar's lower capital cost and larger installed base make it the safer choice. If you anticipate treating OCD, smoking cessation, or complex treatment-resistant cases, BrainsWay's deeper stimulation and broader indication coverage justify the premium.
Insurance and Reimbursement
Both systems use the same CPT codes (90867, 90868, 90869) and receive equivalent reimbursement from Medicare and most commercial payers. TMS reimbursement typically ranges from $250-$450 per session depending on your region and payer mix. A standard 36-session protocol generates $9,000-$16,200 per patient in insurance revenue.
The key reimbursement variable is not the device but the prior authorization process. Most payers require documented failure of at least two antidepressant trials before approving TMS. Practices that tighten the prior auth workflow see higher approval rates and faster time-to-treatment. Both Neuronetics and BrainsWay offer reimbursement support programs, but NeuroStar's larger team and longer market presence give them an edge in payer relationships.
Medicare coverage for TMS is established nationally. Commercial payer coverage varies by state and plan. Before purchasing either system, verify coverage with your top five payers by volume. A system that is technically superior but not covered by your dominant commercial payer is a poor investment.
Installation and Space Requirements
NeuroStar requires a dedicated treatment room of approximately 100-120 square feet. The system includes a treatment chair, the magnetic stimulator, and a control console. BrainsWay's Deep TMS system has a larger footprint due to the helmet-style coil system and requires approximately 120-150 square feet. Both systems require standard 20-amp electrical outlets and no special shielding.
Treatment time differs: NeuroStar standard protocol runs 19-37 minutes per session. BrainsWay's standard protocol runs 20 minutes for MDD. NeuroStar's newer theta burst protocol can complete a session in 3 minutes, which sharply increases daily patient throughput. If chair time is your bottleneck, NeuroStar's theta burst capability is a meaningful advantage.
Frequently Asked Questions
Which is more expensive, NeuroStar or BrainsWay Deep TMS?
NeuroStar runs $80,000-$150,000 new and $40,000-$80,000 used. BrainsWay Deep TMS runs $100,000-$200,000 new and $50,000-$120,000 used. Per-session pricing is $300-$500 (insurance reimbursable) for NeuroStar and $300-$500 (insurance reimbursable) for BrainsWay Deep TMS. Annual operating costs (consumables plus maintenance) typically run 5-15% of purchase price for both devices. The right financial comparison includes total cost of ownership over 5 years, not just sticker price.
Which has better clinical evidence, NeuroStar or BrainsWay Deep TMS?
NeuroStar clinical evidence: Strongest in category. 100+ published studies. 5M+ treatment outcomes registry. Multiple FDA clearances backed by large RCTs. BrainsWay Deep TMS clinical evidence: Strong. Multiple RCTs for depression and OCD. Unique evidence for smoking cessation indication. Evidence quality is not about study count alone. Look at sample sizes, blinded evaluators, independence from manufacturer funding, and outcome durability. Older devices in the same category usually have stronger evidence because they've been studied longer.
Is NeuroStar or BrainsWay Deep TMS more popular in psychiatry practices?
Both NeuroStar and BrainsWay Deep TMS are commonly used in psychiatry, neurology practices. Market share in any given category shifts year to year. Neuronetics and BrainsWay both maintain active sales forces in the US. Ask other physicians in your specialty which platform they're using and why. Peer references in your local market matter more than national market share data.
Are there safety concerns with NeuroStar or BrainsWay Deep TMS?
Both devices are FDA cleared and have established safety profiles. NeuroStar has these documented concerns: Standard TMS depth (~2cm) vs BrainsWay's deep TMS (~6cm). BrainsWay Deep TMS has: Higher upfront cost than NeuroStar. Physicians should monitor FDA MAUDE reports for both devices before purchase. Adverse event trends matter because they signal problems that may not appear in marketing materials. Any device with a sudden spike in MAUDE filings deserves closer scrutiny.
Can I use NeuroStar and BrainsWay Deep TMS in the same practice?
Some practices run both devices, especially when they target different patient segments or treatment areas. The downside is duplicated training, parallel consumable inventories, and potential cannibalization between platforms. The upside is broader marketing claims and the ability to switch patients between platforms if one doesn't deliver expected results. Most practices choose one and commit to mastering it rather than splitting volume.
What's the resale value comparison between NeuroStar and BrainsWay Deep TMS?
Used NeuroStar sells for $40,000-$80,000 on the secondary market. Used BrainsWay Deep TMS sells for $50,000-$120,000. Resale values depend on age, software version, applicator condition, and remaining warranty. Devices with strong installed bases hold value better. Devices with active safety signals or declining manufacturer financial health depreciate faster. Resale value should be a factor in any device purchase, especially if practice plans might change in 3-5 years.
NeuroStar vs BrainsWay Deep TMS: which is better for psychiatry practices in 2026?
For psychiatry practices specifically in 2026, the choice between NeuroStar and BrainsWay Deep TMS depends on three factors: existing equipment compatibility (does the new device integrate with what you already run), patient mix and treatment volume (high-volume practices typically benefit from NeuroStar's first-mover advantage: largest installed base in the us while lower-volume practices often prefer BrainsWay Deep TMS's deepest brain stimulation in tms category (6cm with h-coil)), and total cost of ownership over 5 years including consumables and maintenance. Run the side-by-side TCO analysis with realistic patient volume projections before committing to either platform.
NeuroStar vs BrainsWay Deep TMS: 2026 update on features and clinical evidence?
As of April 2026, both NeuroStar and BrainsWay Deep TMS continue commercial availability from Neuronetics and BrainsWay respectively. Recent updates worth tracking: software releases, new applicator launches, expanded FDA labeling indications, and new peer-reviewed clinical evidence publications. Manufacturer financial stability also matters for long-term support and parts availability. Both manufacturers publish quarterly financial results that inform the long-term outlook for each device.
How do I choose between NeuroStar and BrainsWay Deep TMS for my practice?
Use a structured decision framework: list 5-7 must-have requirements specific to your patient mix and practice economics, score NeuroStar and BrainsWay Deep TMS against each requirement on a 1-5 scale, weight the requirements by importance, then sum the weighted scores. The platform that scores meaningfully higher (10%+ gap) is the right choice. If the scores are within 10%, secondary factors decide: manufacturer relationship, financing terms, training availability, and resale value. Avoid choosing based on feature breadth alone because most devices in this category have similar feature checkboxes. The differentiation is in workflow fit, treatment results, and total cost over 5 years.
Are there better alternatives to NeuroStar or BrainsWay Deep TMS in the tms devices category?
In the tms devices category, NeuroStar and BrainsWay Deep TMS are often the leading platforms but other alternatives may fit specific practice profiles better. Other category options include exomind, magventure, nexstim. Run a 4-platform shortlist evaluation rather than a 2-platform binary because hidden alternatives sometimes outperform on the metrics that matter most to your specific practice.