TMS for Orange County patients

Middletown office (60 Prospect Ave, Third Floor): TMS consultations, psychiatric evaluations, medication management and therapy. This is where most Orange County patients have their first conversation about whether TMS makes sense, and where many continue their regular psychiatric care afterward.

New City office (216 Congers Road, Suite 302): all TMS treatment sessions. We do not deliver TMS in Middletown. Keeping every session in one treatment room means one team, one set of equipment records and one schedule, which is what makes a five-days-a-week course run smoothly.

Telehealth: if the Middletown office is not convenient either, the consultation can be done by secure video from anywhere in New York State. See telepsychiatry in New York.

These are typical off-peak estimates. Morning traffic toward the Palisades and afternoon traffic on NY-17 can add time, so plan a cushion for the first few visits until you know your route.

• Middletown: about 40–45 minutes. NY-17 east to I-87 south, then toward the Palisades Parkway and NY-304 into New City.
• Goshen: about 35–40 minutes. NY-17 east past Harriman, then the same Thruway and Palisades approach.
• Chester: about 30–35 minutes. NY-17 east to the Harriman interchange and south from there.
• Monroe: about 25–30 minutes. Short hop to Harriman, then I-87 south and east toward New City.
• Newburgh: about 35–40 minutes. I-87 south from the Newburgh interchange, or US-9W south along the river toward Haverstraw and then west into New City.

Free on-site parking is available in New City, so there is no circling for a spot before your session.

There is a fair question here: why drive 40 minutes for a treatment you might find closer? Patients who choose us usually give some version of the same three reasons.

The same psychiatrist the whole way through. The doctor you meet in Middletown is part of the same practice that supervises your sessions in New City and continues your care afterward. You are not handed from a referring clinic to a separate TMS center and back again.

Evening and Saturday sessions. New City is open until 7 p.m. on Mondays and Tuesdays and 9 a.m. to 1 p.m. on Saturdays. For commuters, that often means treatment can happen on a day they are already heading south or east.

Short sessions. Most sessions take roughly 20 to 40 minutes depending on the protocol. You are awake, there is no sedation, and you drive yourself home. The round trip plus treatment usually fits in under two hours.

A standard depression course is about 30 to 36 sessions over four to six weeks, with five sessions a week at the start. That is a real commitment from Orange County, and it is worth planning before you begin rather than figuring it out in week two. Patients who finish comfortably tend to use a few of these approaches:

• Stack it with your commute. If you already drive toward Rockland, Bergen or Westchester for work, a session before or after work adds far less than a separate trip from home.
• Use Saturday. A Saturday morning slot can replace one weekday trip each week, which matters most for people who cannot leave work early.
• Book a standing time. Keeping the same appointment time every day makes the routine automatic and lets you plan childcare or carpools around it.
• Keep the other visits local. Check-ins with your psychiatrist, medication changes and therapy can stay in Middletown or by video, so the only trip to New City is the session itself.
• Plan the first week carefully. The first visit includes mapping and dose-finding and runs longer than later sessions. Give yourself extra time that day.

If a daily drive is genuinely not possible right now, tell us. We would rather talk through other treatment-resistant depression options with you than start a course you cannot finish.

Your insurance does not depend on which office you use. Most major plans and Medicare cover TMS for major depression when their criteria are met, typically after antidepressant trials that did not give enough relief. We verify benefits and handle prior authorization before your first session. Details are on the TMS cost and insurance page and the insurance plans page.

Book a consultation at our Middletown office or by video. The psychiatrist will go through your history and past treatments, screen for anything that would make TMS unsafe, and give you a straight answer about whether it is a sensible next step. You can learn more about the treatment on our TMS therapy page or about the office on our Middletown psychiatrist page.