If, after reviewing our admittedly lukewarm evaluation of the VNS data, you decide that you want to offer it to your patients, here’s some useful information.

The procedure is being done primarily at major tertiary medical centers now, but this will change over time. Currently, insurance plans pay for the procedure for depression only on a case-by-case basis, requiring letters of medical necessity before deciding. But most plans fully cover VNS for epilepsy, so presumably it will eventually be covered for depression. The cost is about $16,000 for the device itself and about $4,000 for the surgery.

Psychiatrists will be able to “dose” the device in their offices with the use of a handheld Palm-like computer. Cyberonics will train you for free (the training takes one hour), and, based on what neurologists currently get paid for dosing the device in epilepsy, you will make between $150 and $200 for the 5 to 10 minutes it will take you to turn the (virtual) dials on your handheld.