Referring a Patient for SAINT®: A Guide for Clinicians
Evidence, candidacy criteria, the referral process, and how we coordinate care back to you — for psychiatrists, therapists, and primary care providers treating adults with treatment-resistant depression.
Medically reviewed by Daniel Pietras, MD · Last reviewed: October 2026
SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy) is an FDA-cleared, fMRI-guided accelerated TMS protocol that delivers 50 sessions over 5 days for adults with major depressive disorder (MDD) whose depression has not improved enough on prior antidepressant medication. In the 2022 double-blind randomized controlled trial, 79% of participants reached remission (Cole et al., Am J Psychiatry 2022;179(2):132–141). Individual results may vary. This page is written for clinicians — psychiatrists, therapists, and PCPs — who are considering referring a patient for SAINT® at Neuro Wellness TMS Centers of America (NWCOA), a Verified SAINT® Provider in Coral Springs, Florida.
Evidence Summary for Clinicians
SAINT® uses intermittent theta-burst stimulation (iTBS) delivered in 10 sessions per day over 5 consecutive days (50 total sessions). A functional MRI (fMRI) scan identifies a personalized target in the dorsolateral prefrontal cortex (DLPFC) based on its anticorrelation with the subgenual anterior cingulate cortex (sgACC) — a region often overactive in depression. The Magnus Neuromodulation System, which implements SAINT®, was FDA-cleared in September 2022 (510(k) K220177) and received FDA Breakthrough Device designation.
In the 2022 double-blind randomized controlled trial, 79% of participants who received SAINT® reached remission after the five-day protocol, compared to 13% in the sham control group (Cole et al., Am J Psychiatry 2022;179(2):132–141). Individual results may vary. Remission was defined as a score of 10 or below on the Montgomery-Åsberg Depression Rating Scale (MADRS). Earlier open-label studies from the Stanford research group reported similar or higher remission rates, but open-label designs do not control for placebo effects the way a randomized trial does.
SAINT® is FDA-cleared for MDD in adults. It is not cleared for anxiety, OCD, PTSD, bipolar disorder, or any other condition. The 79% remission figure applies to the SAINT® system specifically — the FDA-cleared SAINT® Neuromodulation System by Magnus Medical — and does not transfer to other accelerated TMS protocols that copy the schedule but not the targeting system. Read the full success-rate analysis.
Candidacy and Exclusions
SAINT® is indicated for adults with major depressive disorder whose depression has not improved enough on prior antidepressant medication. NWCOA treats adults 22 and older. The table below summarizes the key candidacy criteria, the corresponding SAINT® label, and what we need from you as the referring provider.
| Candidacy criteria | SAINT® label | What we need from you |
|---|---|---|
| Diagnosis | Major depressive disorder (MDD) | Confirmed diagnosis of MDD; screening for bipolar disorder and comorbidities |
| Age | Adults 22+ (NWCOA treats adults 22 and older) | Date of birth on referral |
| Prior antidepressant trials | Not enough improvement on prior antidepressant medication | List of medications tried, doses, durations, and outcomes |
| Contraindications | No non-removable magnetic-sensitive metal near the head; no contraindicated implanted devices; no increased intracranial pressure | Relevant medical history, implanted devices, and head metal screening |
| Severity | Treatment-resistant depression (adequate trials without enough relief) | Current PHQ-9 or MADRS score if available |
| Stability | Able to attend 10 sessions per day for 5 consecutive days | Confirmation the patient can commit to the 5-day week and has transportation or lodging arranged |
Contraindications
SAINT® is contraindicated for people with non-removable magnetic-sensitive metal in or near the head, certain implanted devices, or increased intracranial pressure. TMS carries a small risk of seizure. A full contraindication and safety review is completed during the free consultation. Read the full safety profile.
Referral Steps and Turnaround
1. Submit the referral
Complete the referral form below or call us at (954) 827-9793. Include the patient's diagnosis, medications tried (with doses and durations), and your contact information.
2. We contact your patient
Our clinical team reviews the referral and contacts your patient to schedule a free consultation. We handle insurance verification and prior authorization at no cost.
3. Consultation and fMRI targeting
During the consultation, we confirm candidacy, review contraindications, and order the fMRI scan that identifies the personalized stimulation target.
4. The 5-day treatment week
Your patient completes 10 sessions per day over 5 consecutive days at our Coral Springs clinic. Each session lasts about 10 minutes; the full daily visit is typically under 2 hours.
5. We send notes back to you
After the treatment week, we send you a summary with targeting details, treatment parameters, pre- and post-treatment MADRS scores, and follow-up recommendations.
Turnaround: After we receive your referral, our clinical team contacts your patient to schedule a free consultation. Turnaround from referral to the treatment week depends on scheduling and insurance verification. Contact us at (954) 827-9793 for current availability.
Care Coordination Back to the Referring Provider
We treat SAINT® as one step in your patient's overall care, not a handoff. After the consultation, the fMRI targeting, and the five-day treatment week, we send a summary back to you with the targeting details, treatment parameters, pre- and post-treatment MADRS scores, and any recommendations for follow-up. If you are managing medications, we coordinate with you throughout the process.
If your patient does not meet the criteria for SAINT®, or if SAINT® does not produce enough relief, we can discuss other options — standard TMS, SPRAVATO® (esketamine), ketamine, medication management, or psychotherapy — all offered in the same clinic. We will let you know the reason and recommend an alternative path forward so your patient is not left without options. What if SAINT® doesn't work?
No referral fees. NWCOA does not pay referral fees, kickbacks, or revenue share to referring providers. We comply with the Florida Patient Brokering Act and all applicable federal and state laws. Referrals are made for the benefit of the patient, and care is coordinated back to the referring provider.
Peer-to-Peer with Dr. Pietras
Daniel Pietras, MD, is the Medical Director and Psychiatrist at NWCOA. He is board-certified by the American Board of Psychiatry and Neurology (ABPN) and oversees all SAINT® treatment at the clinic. If you would like to discuss a patient's candidacy, the evidence base, or the treatment protocol before referring, Dr. Pietras is available for a peer-to-peer conversation.
Request a peer-to-peer in the referral form's notes field, or call us at (954) 827-9793. Learn more about Dr. Pietras.
Downloadable One-Pager and Referral Form
A printable one-pager summarizing the SAINT® protocol, candidacy criteria, and referral process is available for your practice.
Refer a Patient
Complete the form and our clinical team will review your patient's needs and contact you to coordinate care. We handle insurance verification, prior authorization, and treatment scheduling.
What to include in your referral
- Patient's diagnosis and current symptoms
- Treatment history (medications tried, doses, durations)
- Insurance information if available
- Any specific treatment you are recommending
- Your contact information for coordination
Frequently Asked Questions
Who is a candidate for SAINT®?
Adults 22 and older with major depressive disorder (MDD) whose depression has not improved enough on prior antidepressant medication at adequate dose and duration. SAINT® is FDA-cleared for MDD only — not for anxiety, OCD, PTSD, bipolar disorder, or any other condition. Contraindications include non-removable magnetic-sensitive metal in or near the head, certain implanted devices, and increased intracranial pressure. A free consultation confirms candidacy.
How fast can my patient be seen?
After we receive your referral, our clinical team contacts your patient to schedule a free consultation. Turnaround from referral to the treatment week depends on scheduling and insurance verification, which we handle at no cost. Contact us at (954) 827-9793 for current availability and to discuss urgent referrals.
Will I get notes back?
Yes. After the five-day treatment week, we send you a summary with the fMRI targeting details, treatment parameters, pre- and post-treatment MADRS scores, and follow-up recommendations. If you are managing medications, we coordinate with you throughout. We treat SAINT® as one step in your patient's overall care, not a handoff.
Does NWCOA pay referral fees?
No. NWCOA does not pay referral fees, kickbacks, or revenue share to referring providers. We comply with the Florida Patient Brokering Act and all applicable federal and state laws. Referrals are made for the benefit of the patient, and care is coordinated back to the referring provider.
What if my patient is not a candidate for SAINT®?
If your patient does not meet the criteria for SAINT®, we let you know the reason and recommend an alternative path. NWCOA offers standard TMS, SPRAVATO® (esketamine), ketamine, medication management, and psychotherapy in the same clinic, so your patient is not left without options. We coordinate the alternative back to you.
Cited Research
- 1. Cole EJ, et al. Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial. Am J Psychiatry. 2022;179(2):132-141. PubMed
- 2. Cole EJ, et al. Stanford Accelerated Intelligent Neuromodulation Therapy for treatment-resistant depression. Am J Psychiatry. 2020;177(8):716-726. PubMed
- 3. Cole EJ, Phillips AL, Bentzley BS, et al. Stanford Accelerated Intelligent Neuromodulation Therapy for treatment-resistant depression. Am J Psychiatry. 2021;178(10):898-909. PubMed
- 4. U.S. Food and Drug Administration. 510(k) Premarket Notification — Magnus Neuromodulation System (K220177, September 2022). PubMed
Important Safety Information
SAINT® is not for everyone. It is contraindicated for people with non-removable magnetic-sensitive metal in or near the head, certain implanted devices, or increased intracranial pressure. Possible side effects include headache, fatigue, scalp discomfort and anxiety; TMS carries a small risk of seizure and, as with any depression treatment, a risk of worsening depression or suicidal thoughts. If you are in crisis, call or text 988.
See if SAINT® is a fit, free
Refer a patient for a free consultation, or verify their insurance benefits at no cost. Call (954) 827-9793.
SAINT® is a registered trademark of Stanford University, exclusively licensed to Magnus Medical, Inc. NWCOA is not affiliated with Stanford University.