Medicare covers CT scans, but only when your doctor orders one for a medical reason — not for screening or peace of mind
Medicare Part B pays for CT scans that your doctor considers medically necessary. That means the scan must be ordered to diagnose or monitor a condition your doctor is already treating. Medicare will not pay for a CT scan you request on your own, and it will not pay for screening scans in most cases — even if you have symptoms you're worried about.
The amount you pay depends on whether you've met your Part B deductible for the year, and whether the imaging center is in-network. Most people pay 20 percent of the approved amount after the deductible. The actual bill can range from a few hundred dollars to over $1,000 depending on the type of scan and your location, but Medicare's payment is based on what it considers reasonable, not what the facility charges.
Key Takeaways
- Medicare Part B covers CT scans only when ordered by your doctor for diagnosis or treatment of a medical condition, not for routine screening.
- You pay 20 percent of the Medicare-approved amount after you meet your annual Part B deductible ($240 in 2024).
- The imaging center must accept Medicare assignment for you to pay only the approved amount; out-of-network facilities can bill you more.
- Some CT scans — like lung cancer screening for heavy smokers — may be covered under specific Medicare criteria, but your doctor must order them correctly.
- If Medicare denies the scan as not medically necessary, you have the right to appeal the decision.
When Medicare will and won't pay for a CT scan
Medicare Part B covers a CT scan when your doctor orders it to evaluate a symptom, confirm a diagnosis, or monitor a known condition. Examples include a CT scan of the abdomen to investigate abdominal pain, a chest CT to follow up on a lung nodule, or a head CT after a fall to rule out bleeding. The key is that the scan must address a specific medical problem your doctor is already aware of.
Medicare will not pay for a CT scan ordered for general health screening, even if you have vague symptoms like fatigue or occasional headaches. It also will not pay for a scan you request because you're anxious about your health or because a family member had a similar condition. The ordering physician must document in your medical record why the scan is necessary for your care.
One exception is low-dose CT screening for lung cancer. Medicare covers this scan for people aged 50 to 77 who have a 30 pack-year smoking history (or quit within the past 15 years) and have no symptoms of lung disease. Your doctor must order it through a may have access to lung cancer screening program, and you must receive counseling about the risks and benefits beforehand.
How much you pay out of pocket
Your out-of-pocket cost for a CT scan depends on three things: whether you've met your Part B deductible, whether the imaging center is in-network, and what Medicare considers the reasonable charge for that particular scan in your area.
After you meet your annual Part B deductible ($240 in 2024), Medicare pays 80 percent of the approved amount, and you pay 20 percent. If you haven't met your deductible yet, you pay the full deductible first, then 20 percent of the approved amount. An in-network facility that accepts Medicare assignment can only bill you for your share of the approved amount. An out-of-network facility can charge more, and you may owe the difference between what they charge and what Medicare approves.
The approved amount varies by location and scan type. A straightforward head CT might be approved at $400 to $600, while a more complex abdominal CT with contrast might be approved at $800 to $1,200. The facility's actual charge is often higher, but if they accept assignment, you only pay your 20 percent of the approved amount.
Checking whether your scan will be covered before you go
Before you have a CT scan, ask your doctor's office to contact Medicare or your insurance company to confirm the scan is covered. This is called a pre-authorization check or a coverage information. Your doctor's office can do this by phone or online through Medicare's system.
When you call the imaging center to schedule, tell them you have Medicare and ask whether they accept Medicare assignment. If they do, they will bill Medicare directly and send you a bill for your 20 percent share only. If they don't accept assignment, ask what their full charge is and what Medicare will approve, so you know your maximum out-of-pocket cost.
If Medicare denies coverage before the scan, your doctor can request a review. If Medicare denies it after the scan, you have the right to appeal. The denial notice will explain how to file an appeal and the important date to do so.
CT scans with and without contrast dye
Some CT scans use contrast dye — a liquid you drink or that's injected into your vein — to make certain structures show up more clearly. Medicare covers both types when medically necessary. The contrast itself is included in the scan's cost; you don't pay extra for it.
If you have kidney disease or diabetes, tell your doctor and the imaging center before the scan. Contrast dye can affect kidney function, and your doctor may order blood work beforehand or choose a different imaging method. Medicare will still cover the scan if it's medically necessary, but your doctor needs to know about your kidney health to make the right choice.
What to do if Medicare denies your CT scan
If your doctor ordered a CT scan and Medicare denies it as not medically necessary, you have options. First, ask your doctor why Medicare denied it. Sometimes the denial is because the order didn't include enough detail about your symptoms or diagnosis. Your doctor can resubmit with more information.
If your doctor believes the scan is necessary despite the denial, you can file a formal appeal. The imaging center or your doctor's office can help you start this process. You have 120 days from the denial notice to appeal. During an appeal, a Medicare reviewer will look at your medical record and the reason your doctor ordered the scan.
If you had the scan done anyway and paid out of pocket, you can still appeal. Keep your receipt and the imaging report. If the appeal is successful, Medicare may reimburse you for part or all of what you paid.
Medicare Advantage and CT scans
If you have a Medicare Advantage plan (Part C), your coverage for CT scans is the same as Original Medicare — the scan must be medically necessary — but your out-of-pocket costs may be different. Some Advantage plans charge a copay instead of 20 percent coinsurance. Others have different deductibles or require you to use in-network imaging centers.
Check your plan's coverage documents or call the plan's customer service number before scheduling. Advantage plans can change their coverage rules each year, so what was covered last year may not be this year.
Frequently Asked Questions
Will Medicare pay for a CT scan if I have symptoms but no diagnosis yet?
Yes, if your doctor orders it to find out what's causing your symptoms. The scan doesn't need to confirm a diagnosis — it can be ordered to investigate. But the symptoms must be specific and documented in your medical record. Vague complaints like "I don't feel well" usually won't support coverage.
Do I need to pay the full bill upfront if the imaging center doesn't accept Medicare assignment?
Not necessarily. Ask the imaging center for an estimate of what they'll charge and what Medicare will approve. You can pay your 20 percent share of the approved amount when you have the scan, and the center will bill Medicare for their share. The center may pursue you for the difference between their charge and Medicare's approval, but you can dispute that bill.
Can I get a CT scan at an urgent care or emergency room without Medicare covering it?
If you go to an emergency room or urgent care and the doctor orders a CT scan as part of your treatment, Medicare will cover it the same way — you pay 20 percent after your deductible. The setting doesn't matter; what matters is whether the scan is medically necessary.
What if my doctor wants to repeat a CT scan I had a few months ago?
Medicare will cover a repeat scan if your doctor has a medical reason for it — monitoring a known condition, checking for change, or investigating new symptoms. Medicare won't pay for a repeat scan just because you want another look or because you're anxious. Your doctor must document why the repeat scan is necessary.
Does Medicare cover CT scans at imaging centers that advertise "full body" screening?
No. Full-body CT screening for people without symptoms is not covered by Medicare. These are marketed as wellness scans, and Medicare considers them screening rather than diagnostic. If you have a specific symptom or condition your doctor wants to investigate, that's different — but a general screening scan is your cost alone.