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About Dr Greg Marsella2019-06-29T09:07:40+00:00

Curriculum Vitae

CAREER

March 1997- Present
Principal Investigator: Da Vinci Research Institute
Boca Raton, Florida
Contract Clinical Trials and Grant-Based Medical Research

April 1992-Present
Private Practice of Adult and Adolescent Psychiatry/Psychopharmacology
Boca Raton, Florida
Miami, Florida

November 2009-Present
Neuronetics Neurostar rTMS and Brainsway rDTMS Therapy
Chrysalis TMS Institute
Boca Raton, Florida
Miami, FloridaRepetitive Transcranial Magnetic Stimulation
Deep Repetitive Transcranial Magnetic Stimulation

BRIEF CLINICAL RESEARCH BIOGRAPHY

Gregory Marsella is a co-founder of Da Vinci Research Institute, a small, independent clinical research company that does grant-based medical research and also offers local, contract research services to Fortune 500 pharmaceutical companies, biotechnology companies, and national CRO’s. Dr. Marsella is a physician by training and a board certified psychiatrist who received his B.A. at Harvard, his M.D. at the University of Pennsylvania, and his residency training in psychiatry at New York Hospital-Cornell Medical Center. In addition to its other missions, Da Vinci Research Institute is a medical research network furnishing study-procural, patient-recruitment, site-management, and research administrative service for its participating practices in Florida. Dr. Marsella has been the principal investigator for over 30 Phase II, III, and IV multi-center, nationwide clinical trials over the past 20 years, and has also authored and implemented grant-based medical research studies in child and adult psychopharmacology, neurology, epilepsy medicine, pain-management, and rheumatology.

EDUCATION

July 1987-April 1992
Delray Medical Center
Delray Beach, Florida
Director of Adolescent Psychiatric Treatment Services
Medical Director of Adolescent Psychiatric Inpatient Unit

1984-1987
New York Hospital-Cornell Medical Center-Westchester
Psychiatry Residency

1983-1984
New York Hospital-Cornell Medical Center-Payne Whitney;
New York Hospital-Cornell Medical Center-Westchester;
Memorial Sloan-Kettering Cancer Center;
Laguardia Hospital-Forest Hills
Internship

1978-1983
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
Doctor of Medicine Degree

1971-1976
Harvard University
Cambridge, Massachusetts
B.A. Degree Cum Laude in English Literature;
Thesis Rank: Magna Cum Laude

PSYCHIATRIC EDUCATION

Medical School
-8 week clerkship in Adult Psychiatry, Hospital of the University of Pennsylvania (HUP)
-8 week externship in Advanced Inpatient Psychiatry, HUP
-4 week clerkship in Child Psychiatry, Philadelphia Child Guidance Clinic, HUP
-4 week Specialized Study in Psychiatry (Psychoanalysis), HUP

Internship
-2 months Neurology, Memorial Sloan-Kettering Cancer Center
-4 months Medicine, Laguardia Hospital-Forest Hills
-2 months Geriatric Psychiatry, New York Hospital-Cornell Medical Center
-2 months Drug and Alcohol Rehabilitation, New York Hospital-Cornell Medical Center
-2 months Psychiatric Evaluation Service, New York Hospital-Cornell Medical Center

Psychiatry Residency
-6 months Diagnostic Evaluation Services, New York Hospital-Cornell Medical Center
-6 months Psychiatric Inpatient Services, New York Hospital-Cornell Medical Center
-12 months Adult Outpatient Psychiatry, New York Hospital-Cornell Medical Center
-3 months Child and Adolescent Psychiatry, New York Hospital-Cornell Medical Center
-6 months Adolescent Inpatient Services, New York Hospital-Cornell Medical Center
-3 months Consultation-Liaison Services, New York Hospital-Cornell Medical Center

MEMBERSHIPS

American Medical Association
American Psychiatric Association
American Academy of Child and Adolescent Psychiatry

LICENSURE AND CERTIFICATIONS

Florida Medical License: ME 0051261
New York Medical License: 161138-1
DEA: Available upon request
GCP Certification 2010

BOARD CERTIFICATIONS

Diplomate in Psychiatry, American Board of Psychiatry and Neurology, Certificate 42544 (1996-2016)
Diplomate in Psychiatry, National Board of Physicians and Surgeons (2016-2020)
Diplomate, National Board of Medical Examiners

HOSPITAL PRIVILEGES

West Boca Medical Center, Boca Raton, Florida
Delray Medical Center, Delray Beach, Florida

COVERAGE

24 Hour Coverage by Voicemail/Emergency Beeper
Vacation/Out-Of-Town Same-Office Coverage by Colleagues

PRACTICE DESCRIPTION

General Adult and Adolescent Psychiatric Consultations
Adult and Adolescent Psychopharmacology
Repetitive Transcranial Magnetic Stimulation (rTMS)
Deep Repetitive Transcranial Magnetic Stimulation (rDTMS)
Contract Clinical Trials and Grant-Based Medical Research

Boca Raton Office

8000 N Federal Hwy, Suite 110, Boca Raton, Florida 33487

HOURS

  • By Appointment Only

  • Monday – Sunday

  • 5pm – 10pm

  • Office or Skype Appointments Available for Boca Raton or Miami patients

Services Available

  • Evaluations

  • Medication Management

  • TMS Treatments

  • Clinical Research

Miami Office

1951 NW 7th Ave, Suite 300, Miami, Florida 33136

Hours

  • By Appointment Only

  • Monday – Sunday

  • 9am – 6pm

  • When you arrive, call your technician and they’ll bring you upstairs to the office

Services Available

  • TMS Treatments Only

contact us for more information
What is Genetics Testing, Why Should I Be Interested, and How Much Does it Cost?2019-06-19T14:29:18+00:00

Why should I be interested in genetic testing?

Up to half of all patients respond poorly to the first psychiatric medicine they try because everyone’s body is different, partially based upon their own individual genetic makeup.

Genomind® Professional PGxTM looks at key genes in your body’s DNA that affect how it responds to medication. This can help Dr. Marsella understand if a drug may work for you before you even try it. With this information, along with your medical history, he can find the right treatments so you can feel better quicker.

How do I pay for the test?

If your cost will be more than $325 (US residents only), Genomind will call you before processing your test.

Please contact Genomind at 877.895.8658 to discuss billing, financial assistance, or any health insurance-related questions

  • Employer, other insurance or Medicare Advantage: These parties may expect you to cover a portion of the test cost.
  • Medicaid and Managed Medicaid — If you have a Medicaid or Managed Medicaid Plan, your cost will be $0 since there is no co-payment or deductible associated with laboratory testing in these programs.
  • Uninsured — Please call Genomind at 877.895.8658 for financial assistance.
Can I Get More Than 1 TMS Treatment a Day?2019-06-19T14:11:39+00:00

NeuroStar

We can do up to 3 TMS treatments per day (7 days a week), as long as there is a 2 hour window between each treatment.

Brainsway

We can do up to 4 TMS treatments per day (7 days a week), with an hour interval between each treatment.

Brainsway TMS Treatment Protocol for OCD2019-06-19T14:08:09+00:00

15 to 20 mins
29 treatment sessions
5 days per week

100% leg MT intensity
20Hz frequency
2 sec train duration
20 sec inter-train interval
50 trains
2000 pulses

TMS Treatment Protocol for Depression2019-06-19T14:07:31+00:00

NeuroStar

40 mins to 2 hours
20-36 treatment sessions
5 days a week

120% of MT
3000 pulses

Brainsway

15 to 18 minutes
36 treatment sessions
5 days a week

120% of MT
18Hz
2 sec interval
20 sec inter-train interval
55 trains
1980 pulses

How Long Before I Can Tell if the TMS Treatments are Working?2019-06-19T13:57:02+00:00

Most patients who benefit from TMS Treatment experience results by the fourth week of treatment. Some patients may experience results in less time while others may take longer. And there are still other patients who do not experience any relief of symptoms until after the 36th

Keep in mind that either you or the doctor may discontinue treatment at any time.

What Preparations Do I Need to Make Before TMS Treatment?2019-06-19T13:53:42+00:00

Before arriving for your TMS treatment, please remove any hair accessories, hat, jewelry, eyeglasses. When you come for your first OCD treatment, please be prepared to remove shoes as well. This is the only time you will need to remove your shoes. Additionally, before the treatment begins, you will be given ear plugs to wear to minimize noise.

Are There Any Risks Associated with TMS Therapy?2019-06-19T13:43:36+00:00

The following risks are also involved with this treatment:

The TMS Treatment System should not be used by anyone who has magnetic-sensitive metal in their head or within 12 inches of the magnetic coil that cannot be removed. Failure to follow this restriction could result in serious injury or death. Objects that may have this kind of metal include:

  • Aneurysm clips or coils
  • Stents
  • Implanted Stimulators
  • Electrodes to monitor your brain activity
  • Ferromagnetic implants in your ears or eyes
  • Bullet fragments
  • Other metal devices or objects implanted in the head.

TMS Treatment is not effective for all patients. Any signs or symptoms of the worsening of the condition you are receiving TMS for should be reported immediately to Dr. Gregory Marsella and/or Chrysalis TMS Institute, Inc. staff. You may want a family member or caregiver to monitor your symptoms to help you spot any signs of worsening for the condition you are seeking TMS therapy for.

Seizures (sometimes called convulsions or fits) have rarely been reported with the use of TMS devices. However, after the 10,000 TMS sessions at Chrysalis TMS Institute no seizures were observed.

Because the TMS Treatment system produces a loud click with each magnetic pulse you must wear earplugs or similar hearing protection devices with a ration of 30dB or higher of noise reduction during treatment.

What is TMS?2019-06-19T13:41:00+00:00
  1. TMS stands for “Transcranial Magnetic Stimulation”. TMS Treatment is a medical procedure. A TMS treatment session is conducted using a device called either NeuroStar TMS or Brainsway Deep TMS, which provides electrical energy to a “treatment coil” or magnet that delivers pulsed magnetic fields. These magnetic fields are the same type and strength as those used in magnetic resonance imaging (MRI) machines.
  2. TMS Treatment is a safe and effective treatment for patients with depression who have not benefited from antidepressant medications, and has been FDA cleared to treat depression symptoms in adult patients who have been treated with antidepressant medication given at a high enough dose and for a long enough period of time but did not get better.
  3. In 2018, the FDA cleared Brainsway for a new helmet to treat Obsessive Compulsive Disorder (OCD).
What Can I Expect During TMS Treatment?2019-06-19T13:39:04+00:00
  1. During a TMS treatment session, Dr. Marsella or a member of his staff will place the magnetic coil gently against the scalp on the left and/or the right front region of the head (if using the NeuroStar TMS device); or will place a helmet with magnetic pulses over left and right hemispheres (if using the Brainsway Deep TMS device). The magnetic fields that are produced by the magnetic coil are pointed at a region of the brain that scientists think may be responsible for causing many different conditions. However, currently the only condition FDA cleared is depression.
  2. To administer the treatment, Dr. Marsella or a member of his staff will first position the head in the head support system. Next, the magnetic coil will be placed on the left and/or right side of the head and you will hear a clicking sound and feel a tapping sensation on your scalp (if using NeuroStar TMS device); or if using Brainsway Deep TMS device, will place a helmet, tilted towards the right and front over your head and you will hear a clicking sound and feel a tapping sensation on your scalp. The doctor will then adjust the TMS Treatment so that the device will give just enough energy to send electromagnetic pulses into the brain so that your right-hand twitches. The amount of energy required to make the hand twitch is called the “motor threshold”. Everyone has a different motor threshold and the treatments are given at an energy level that is just above your individual motor threshold. How often your motor threshold will be re-evaluated will be determined by Dr. Marsella. For OCD motor thresholds, we will be looking for movement below the knee in either leg. The helmet will be placed at the vertex of your head.
  3. Once motor threshold is determined, the magnetic coil (NeuroStar), or helmet (Brainsway), will be moved, and you will receive the treatment as a series of “pulses”, with a “rest” period. If receiving the FDA cleared treatment, that “rest” period lasts about 20-30 seconds between each series. If Dr. Marsella chooses to use an off-label treatment for your condition, that time may vary. FDA cleared treatment using the NeuroStar TMS system is to the left front side of the head and will take about 20-45 minutes. If Dr. Marsella decides to use an off-label research protocol the time may be shorter or longer. It could take anywhere from 15 minutes to an hour and a half. The Brainsway helmet covers the entire head and will take about 15-18 minutes. Understand that this treatment does not involve any anesthesia or sedation and that you will remain awake and alert during the treatment. You will initially receive these treatments 5 times a week for 4 weeks (20 treatments) and you should understand that additional treatments may be required in order to achieve maximum response, whether using the FDA cleared method or the off-label method Dr. Marsella chooses.
  4. During the treatment, you may experience tapping or painful sensations at the treatment site while the magnetic coil is turn on. These types of sensations were reported by about one third of the patients who participated in the research studies. You should inform the doctor or his staff if this occurs. The doctor may then adjust the dose or make changes to where the coil or helmet is placed in order to help make the procedure more comfortable. Headaches were reported in half of the patients who participated in the clinical trial for the device. Both discomfort and headaches got better over time in the research studies and you may take common over-the-counter pain medications such as acetaminophen if a headache occurs.
What is Your Financial Policy?2019-06-19T14:24:33+00:00
COST
Initial Consultation: $500.00**

This service is provided by Gregory Marsella, M.D.  Initial consultation is a 1-2 hour medical/psychiatric evaluation. Fee is collected 48 hours in advance of the initial consultation and is non-refundable if the appointment is missed.

Pharmacogenomics Testing: $50.00**

This is a genetic test which assesses a patient’s genetic vulnerability to specific psychiatric diagnoses and potential responsiveness to different medications based on underlying genetic susceptibility. We collect a $50.00 fee to perform, process, and ship your sample. Interpretation of results is $500. Genomind will bill your insurance company on your behalf. If you have any questions regarding Genomind’s billing process or insurance questions, please contact them at 877.895.8658

Appointments

$250.00 (20-30 minutes)

$300-400 (30-50 minutes)

$500 (60 minute block)

Payment: We accept most forms of payment including Cash, Check, and Credit card.
Reimbursement:

An initial consultation and subsequent appointments with Dr. Marsella may be covered by insurance but reimbursement will depend on your specific mental health insurance policy. Payment is due at the time of service.  We will furnish you with a specific kind of payment receipt (referred to in health insurance company terms as a “Superbill”) that you can submit to your health insurance entity for reimbursement.

**Fees are subject to change without notice

Why Does Dr. Marsella Sometimes Take My Vitals, Perform EKG’s, or Order Blood Work?2019-06-19T13:29:04+00:00

Dr. Marsella may collect vital signs or order blood work or EKG’s to monitor for possible metabolic influences from medications he may prescribe to you. Blood workup and EKG’s are covered by your health insurance as if Dr. Marsella were an in-network provider. There is no fee for vital signs, heights and weights, etc.

What Other Services Does Dr. Marsella offer?2019-06-19T14:26:34+00:00

Dr. Marsella is currently one of a small group of psychiatrists in the country to offer the Neuronetics company’s rTMS (repetitive Transcranial Magnetic Stimulation) Therapy (for Depression), and the Brainsway company’s Deep rTMS Therapy (for Depression and OCD), both of which are FDA-approved non-invasive magnetic treatments. rTMS and Deep rTMS are also used in leading centers to treat bipolar disorder, anxiety disorders, pain, tinnitus, migraine, PTSD, Post-partum Depression, Post Stroke Rehabilitation, and many other psychiatric and neurologic diagnoses, but are considered experimental therapies. Dr. Marsella also offers in-house genetics testing (specifically the Genomind Professional PGx ®, which is a cheek swab that can measure and predict your unique, differential sensitivity to prescribed psychoactive medications, supplements, to non-systemic treatments like rTMS, Deep rTMS, and ECT, and to specific psychotherapies and behavior therapies, all based on your own unique genetic information. For questions regarding Genomind’s billing process, or if you have insurance questions, please contact Genomind at 877.895.8658. Dr. Marsella charges a $50 collection fee, and interpretation of results costs $500.

How Do I Request Medication Refills?2019-06-19T13:23:14+00:00

You can personally request medication refills by a telephone call, voicemail, or text to Dr. Marsella’s assistant (assistant’s cell will be provided to you). Please include:  Name, Date of Birth, Dosage and Name of Medication, and your Pharmacy Telephone #. We prefer personal requests, but if so desired you may ask your pharmacy to make your refill requests for you, but in this case inform your pharmacy that their request MUST be made by Telephone only, NOT by email or by fax. Phone #: 561-394-2532

What Do I Do if I Need to Get in Touch with Dr. Marsella After Hours?2019-06-19T13:12:24+00:00

If you need to leave a message for Dr. Marsella outside of his normal practice hours, you may record a voicemail by calling 561-394-2532. IF YOUR CALL IS URGENT you may dial # (pound) once you’re finished recording, and follow the prompts to mark the message as “urgent.” However if you are dealing with an emergency situation or possible overdose DO NOT wait for a return call. Call 911 or go to your nearest emergency room immediately.

Do you take Medicare or Medicaid?2019-06-19T13:07:27+00:00

Dr. Marsella does not take Medicaid. He is also a Medicare ‘opt-out’ provider, meaning that you can not submit for reimbursement from Medicare for any of the services he offers.

What Insurance Do You Take for TMS Treatments?2019-06-19T13:10:25+00:00

Currently we take Cigna and Avmed (Magellan). Additionally, we are quite successful receiving prior authorizations and single case agreements with the following companies: Aetna and United Health Care (Optum). For the aforementioned insurance companies, once you receive prior authorization, you would only be responsible for your deductible (if applicable) and any co-pays associated with the service and your benefits policy.

For people who are requesting TMS treatments that aren’t covered by your insurance, or have an insurance company that is not listed, we offer Superbills that you may submit to your insurance company so that you may be reimbursed at Out-of-Network rates.

It should be noted that Dr. Marsella has ‘opted out’ of Medicare, meaning that you will not be reimbursed for any Medicare services Dr. Marsella offers.

We also work with the Veteran’s Administration (VA) for TMS treatments for Major Depressive Disorder and Post Traumatic Stress Disorder (PTSD). Please contact us for more information.

Does Insurance Cover TMS?2019-06-19T13:09:56+00:00

Yes, insurance will cover TMS if you are suffering from Treatment Refractory Major Depressive Disorder and fulfill the diagnostic criteria. Some of those criteria include having been on an optimal dose of three previous antidepressants for a period of 2-3 months, with and without adjunctive (add-on) antidepressant therapy. Additionally, the insurance companies generally also want to see a history of regular psychotherapy. Generally, insurance companies will also require that this is ongoing throughout your TMS treatments. There are also assessments for depression that you will need to take before starting TMS or receiving approval to illustrate symptom severity. These assessments will also be given regularly throughout your treatment to assess progress.

Insurance does not cover any other indication for TMS. Recently, Brainsway received FDA clearance for an OCD helmet to treat Obsessive Compulsive Disorder. Because this is still a new indication, insurance companies have not yet created policy guidelines for the pre-authorization of this treatment.

The one exception to this is the Veteran’s Administration, which will cover TMS treatments for Post Traumatic Stress Disorder (PTSD).

How Do I Submit a Superbill?2019-06-19T12:53:22+00:00

Your Superbill contains information such as your name, date of birth, diagnostic and procedure coding. In order to obtain reimbursement, simply enclose the Superbill in a regular sized envelope and mail it to the claims filing address provided on the reverse side of your insurance card (sample shown below).

What is a Superbill?2019-06-19T12:51:36+00:00

A Superbill is not a bill but is a standardized medical invoice and receipt that includes the specific medical and diagnostic information that enables your insurance company to quickly reimburse you for your visits with Dr. Marsella as an out-of-network provider. All blood tests and diagnostic or genetics tests ordered for you by Dr. Marsella will be paid for directly by your health insurer, just as if Dr. Marsella were an in-network provider.

Does Dr. Marsella Take Insurance?2019-06-19T14:27:49+00:00

Dr. Marsella does not take insurance for any of his appointments. We do provide you with a superbill to submit to your insurance company for reimbursement (based on your policy limits for Out-of-Network Providers). Please contact Karina at 561-394-2532 for any superbill related questions.

For TMS treatments, we do work with select insurance companies (Aetna, UHC/Optum, Avmed/Magellan, Cigna).

The genetics testing is offered is through Genomind. We collect your insurance information and submit to them with your genetic sample. If there are any charges associated with the test, Genomind will bill you directly. If you have any questions regarding Genomind’s billing, please contact them at 877.895.8658.

Does Dr. Marsella Make House Calls2019-06-19T12:28:55+00:00

Yes, the doctor is available for house calls. Please contact Karina at 561-394-2532 for more information.

Are Skype Appointments Available?2019-06-19T12:29:28+00:00

Skype appointments and phone appointments are available to all patients. Dr. Marsella usually prefers evaluations to be in person. Exceptions are made when travelling long distance is not an option for the patients or their families. In these cases, Skype appointments are allowed.

What is the Doctor’s Availability?2019-06-19T12:30:08+00:00

Dr. Marsella often sees patients after 5pm — Tuesday, Thursday, and Saturdays in his Boca office. Appointments on other days are also available if you need an urgent appointment. For all of your scheduling requests, please contact Karina, his administrative assistant, and she can assist you.

Does the Doctor Run On Time?2019-06-19T12:30:57+00:00

Dr. Marsella works hard to ensure that every patient has their needs attended to during their session. This sometimes will cause a normal appointment (ex. 30 minutes) to run longer (ex. an hour or more). While this is good for the patient he is currently sitting with, sometimes frustration can arise while waiting for your appointment. Keep in mind, that when you go in for your appointment, your needs will be given the same consideration. Dr. Marsella is very thorough and wants to ensure that every patient understands his recommendations or treatment suggestions. Every effort will be made by the staff to notify you if the doctor is running late and by how much. If having to wait to see the doctor is too frustrating for you, then you might want to consider another doctor.

Additionally, in medicine, there are often patient emergencies that must be dealt with. Dr. Marsella ensures that if a patient is in crisis he can devote his full attention to them. Sometimes this means that he will have same day cancellations of appointments, in order to free his time to handle a patient’s crisis. We ask that you please be patient with the staff and understand that as soon as these changes are known, they will contact you (either by text or phone call) at the number you have listed at intake.

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