TMS & Spravato ROI Calculator · For your clinic
Your clinic’s TMS & Spravato ROI.
You already know this problem. It doesn’t show up in your P&L, yet.
Between treatment sessions, patients silently relapse, discontinue, or drop out — and you have zero visibility into it happening. Patients who shouldbe coming back for billable follow-up courses are simply lost. What you haven’t had is a tool that makes it visible, and recoverable.
Emobot turns those invisible patient losses into a new, measurable revenue line, by detecting deterioration early and keeping patients engaged in treatments that work. Better clinical outcomes. New revenue. Same patient base.
Below is a working model for the three key revenue leaks in interventional psychiatry: TMS 2nd-course recapture, Esketamine maintenance retention, and TMS dropout prevention. Every assumption is editable. Skip to the three pre-computed scenarios at the bottom if you want the headline numbers first.
Per clinic · Net benefit
$142k
Net ROI
2.9×
Payback
3.1 mo
Step 1: Your revenue base
How many revenue-generating patients does a typical clinic see?
Interventional psychiatry has two high-value treatment lines: TMS (Transcranial Magnetic Stimulation, ~$9k/course) and Esketamine / Spravato(~$7.8k/course). We only count these active patients in the model. Other visits (IV ketamine, consults) can be monitored too, but we don’t credit them with revenue lift, which keeps this estimate conservative.
TMS patients
120
60% of active patients
36 sessions · $250 net/session · $9,000 / course
Esketamine patients
80
40% of active patients
12 sessions · $650 net/session · $7,800 / course
Drag to adjust the TMS ↔ Esketamine split
60% TMS · 40% Esketamine
Step 2: Unit economics per patient
What does your clinic actually keep per treatment course?
Net revenue= what the clinic keeps after insurance discounts, drug cost (Esketamine is a branded medication with buy-and-bill economics), and admin overhead. These are the numbers that flow to your clinic P&L. Defaults use typical US net reimbursement; adjust to match your actual payer mix.
36 sessions × $250 net = $9,000 per patient.
Most US commercial + Medicare plans cover a 2nd course within 12 months.
12 sessions × $650 net = $7,800 per patient.
Dropouts leave ~18 sessions unbilled × $250 = $4,500 lost.
≈ 1 additional maintenance course (12 sessions × $650) over 6 months.
Step 3: The hidden P&L problem
Three revenue leaks your clinics live with every day.
Your Clinical Directors know these numbers intuitively; they see patients disappear between visits and never rebook. But these leaks rarely surface in financial reporting because they look like “normal attrition,” not lost revenue.
Each card below shows the industry reality today vs. what the same metric would look like if you could intervene early. The gap between the two is the revenue Emobot recovers.
Leak 1 · TMS patients who come back for a 2nd course
TMS works, but patients relapse. When they do, a 2nd course is fully reimbursable ($9k). Today, 80% of those patients never come back. That's revenue your clinic already earned the right to, but doesn't capture.
Today (industry)
~20%
In an ideal world
40–50%
Dunner 2014 (42 US sites, 257 patients): 36.2% of responders retreat → ~20% of all starters. Ideal ~50% assumes every patient who relapses and would benefit comes back.
Leak 2 · Esketamine patients who stay on maintenance
Esketamine (Spravato) is your highest-margin treatment, but 80% of patients discontinue within 12 months, and half of those relapse within 6 months. Each retained patient is worth another $7.8k/year in billable sessions. This is the single biggest revenue leak in most IP clinics.
Today (industry)
~20%
In an ideal world
60–70%
ESKALE 2024 (France): 79.6% discontinue by Y1. 50% relapse at 6 months post-discontinuation. Ideal 60–70% = patients who respond to acute induction and stay engaged on maintenance.
Leak 3 · TMS patients who drop out mid-course
24% of TMS patients don't finish the full 36-session course. Each dropout leaves ~18 unbilled sessions on the table ($4,500). Over a third cite 'personal reasons' (not medical ones), meaning these are preventable with the right engagement.
Today (industry)
~24% drop
In an ideal world
5% drop
Sackeim 2020 (NeuroStar Registry, 5,010 patients): 24% don't complete. Ideal ~5% covers only medically-necessary stops. 36.6% of current dropouts are for 'personal reasons' (Lapid Brown 2025).
Step 4: What Emobot changes
Closing the gap between “normal attrition” and recoverable revenue.
How it works, in business terms: Emobot is a passive monitoring layer your patients install once (3 minutes, no training). It runs in the background on their phone, detects early signs of deterioration using AI, and alerts your clinical team, who then schedule a follow-up before the patient silently drops off.
The result: more patients come back for billable follow-up courses, fewer drop out mid-treatment, and your maintenance revenue holds. The defaults below are conservative floors, benchmarked against Neuronetics’ own TrakStar engagement program, which proved a +20% lift with simple scheduled touchpoints. Emobot’s continuous monitoring is designed to exceed that.
Relative lift on today’s 2nd-course rate. Neuronetics TrakStar: +20% via simple scheduled touchpoints. Emobot continuous monitoring ≥ that floor.
Absolute percentage-point gain (e.g. retention rate goes from 20% → 35% = +15pp).
Absolute pp reduction. 36.6% of dropouts cite “personal reasons” (Lapid Brown 2025), directly addressable by continuous monitoring + nudges.
Step 5: Cost structure
Predictable SaaS spend. No hardware, no integration, no FTEs.
Emobot is a pure software subscription: no devices to purchase, no EHR integration required, no new staff needed. Pricing scales with patient volume (larger clinics pay less per patient), and you’re only billed on months the patient is actually engaged with the app (≥16 days of data). Zero shelfware risk.
Emobot pricing tiers
1–50 patients
$49/pt/mo
51–150 patients
$39/pt/mo
151+ patients
$29/pt/mo
Your clinic (200 patients) → 151+ tier at $29/pt/mo
Only engaged months are billable. Benchmarks suggest 70–80% with Emobot’s onboarding flow.
Emobot annual cost for this clinic
$48,720
200 patients × $29/mo × 12 mo × 70% engaged = $48,720
Step 6: Revenue impact breakdown
Three new revenue lines from your existing patient base.
No new patients required. Each line below recovers revenue from patients you’re already treating: patients who would otherwise silently drop off your books. Numbers update live from the inputs above.
Leak 1 closed · TMS 2nd-course recapture
More TMS patients come back for a reimbursable second course.
24 patients come back today → 29 with Emobot (+5 patients × $9,000)
Revenue added
+$43,200
Leak 2 closed · Esketamine Y2 retention
More Esketamine patients stay on maintenance into Year 2.
16 retained today → 28 with Emobot (+12 patients × $7,800)
Revenue added
+$93,600
Leak 3 closed · TMS acute-course completion
Fewer TMS patients drop out mid-treatment.
29 drop out today → 17 with Emobot (12 patients retained × $4,500)
Revenue added
+$54,000
Total revenue added
+$190,800
− Emobot cost
−$48,720
= Net benefit
+$142,080
Net ROI
2.9×
Revenue multiple
3.9×
Three scenarios · board-ready
The executive summary. No sliders needed.
Both scenarios below use the same conservative lift assumptions and Emobot's published pricing. The only variable is clinic size, which determines the pricing tier. Switch to network mode above for the multi-site rollup.
Scenario A
Small clinic
75 active patients · $39/pt/mo tier
Inputs
- • 75 patients (45 TMS / 30 Esketamine)
- • $39/pt/mo pricing tier (51–150)
- • 70% engaged months
Scenario B
Typical mid-size clinic
200 active patients · $29/pt/mo tier
Inputs
- • 200 patients (120 TMS / 80 Esketamine)
- • $29/pt/mo pricing tier (volume)
- • 70% engaged months
One-line takeaway for each scenario
- A · Small clinic (75 pts): at $39/pt/mo, Emobot pays itself back in 4.1 months and adds $47k of net margin per year.
- B · Typical mid-size clinic: at $29/pt/mo on 200 patients, payback is 3.1 months and each clinic generates $142k of net benefit annually: 2.9× ROI.
Methodology & references
Every number has a source.
ROI definition
ROI = (Gain − Cost) / Cost. The headline Net ROI is the per-dollar net return on Emobot spend, not a gross revenue multiple. Gross revenue multiple is shown separately for reference.
Net revenue defaults
TMS course = 36 sessions × $250 net/session = $9,000 per patient. Esketamine course = 12 sessions × $650 net/session = $7,800 per patient. All figures reflect typical US net reimbursement after payer discounts, cost of goods (Esketamine), and admin overhead.
Emobot pricing
Volume-tiered monthly SaaS: $49/pt/mo for 1–50 patients, $39/pt/mo for 51–150, $29/pt/mo for 151+. Billed only on months the patient hits the 16-day data threshold in a rolling 30-day window (aligned with Medicare RTM CPT standards, 2027 track). No Anti-Kickback or Stark exposure.
Leak 1: TMS retreatment
Dunner DL et al. 2014, J Clin Psychiatry 75(12):1394–1401. 42 US clinical sites, 257 patients. 36.2% of TMS responders returned for retreatment within 12 months → ~20% of all starters.
Leak 2: Esketamine retention
ESKALE French cohort 2024 (PMC 11919239): 79.6% of esketamine patients discontinue within 12 months. 50% of those who discontinue relapse within 6 months. Komodo Research Database: median time-to-discontinuation of 8.2 months.
Leak 3: TMS dropout
Sackeim HA et al. 2020 — NeuroStar Registry, 5,010 patients, 103 US sites. 24% of TMS starters do not complete the acute course. Lapid Brown et al. 2025 (VA, n=1,588): 36.6% of dropouts cite “personal reasons.”
Emobot lift: TMS 2nd-course recapture
Neuronetics IR release, Oct 2023. TrakStar scheduled touchpoints drive a +20% lift in 36-session completion. Emobot continuous monitoring ≥ that floor.
Emobot’s monitoring accuracy
Correlation with PHQ-9: r = 0.83. Correlation with MADRS: r > 0.7 across three independent clinical studies. FDA 510(k) filed January 2026.
Next step
Ready to pressure-test these numbers against your network’s own data?
Confidential · prepared for your leadership team · Not for external distribution