What G0180 is and when Medicare pays for it

G0180 is a screening test for abdominal aortic aneurysm (AAA) — a bulge in the large blood vessel that runs through your belly. Medicare covers this ultrasound screening once in your lifetime if you meet specific conditions. The test itself is painless and takes about 10 minutes.

Medicare Part B pays for G0180 only if you are a man between 65 and 75 years old who has ever smoked, or if you are any age and have a family history of abdominal aortic aneurysm. If you are a woman, Medicare does not cover this screening unless you have a documented family history of AAA. The test must be ordered by your doctor and performed at a Medicare-approved facility.

The screening is covered at no cost to you — you pay nothing out of pocket if your doctor orders it and you meet the age and smoking or family history requirements. If you do not meet these conditions, Medicare will not pay, and you would be responsible for the full cost.

Key Takeaways

  • Medicare covers G0180 once in a lifetime for men 65–75 with a smoking history, or for anyone with a documented family history of abdominal aortic aneurysm.
  • Your doctor must order the test; you cannot request it directly from an imaging center and expect Medicare to pay.
  • The test must be done at a Medicare-approved facility, which your doctor's office can confirm before scheduling.
  • If you meet the criteria, there is no copay, coinsurance, or deductible — Medicare covers the full cost.
  • If you do not meet the age, smoking, or family history requirements, Medicare will deny the claim and you will owe the facility directly.

How to start: talking to your doctor

The first step is to tell your primary care doctor or cardiologist that you want to know whether you are a candidate for AAA screening. Bring up your smoking history (current or past) and ask whether anyone in your family has had an abdominal aortic aneurysm. Your doctor will review your medical record and Medicare's coverage rules to decide whether the test makes sense for you.

If your doctor agrees you meet the criteria, they will place an order for G0180 at an imaging center. You do not need to do anything else at this stage — your doctor's office handles the paperwork. If your doctor says you do not meet Medicare's requirements, that is the end of the road; Medicare will not cover the test, and paying out of pocket is your only option.

Finding a Medicare-approved imaging center

Once your doctor has ordered the test, ask their office which imaging centers they work with and which ones accept Medicare for G0180. Most hospitals and large imaging centers are Medicare-approved, but smaller or specialty clinics may not be. Your doctor's office usually knows this already and will steer you to a place that is set up to bill Medicare.

You can also call Medicare directly at 1-800-MEDICARE to ask for a list of approved ultrasound providers in your area, though your doctor's office recommendation is usually faster. When you call to schedule, tell the imaging center that you have a Medicare order for G0180 and ask them to confirm they are in-network for your plan. If you go to a facility that is not Medicare-approved, you will owe the full bill.

What happens at your appointment

On the day of your test, bring your Medicare card and photo ID. The ultrasound technician will explore a clear gel to your belly and use a handheld probe to take images of your aorta. The test takes about 10 minutes and causes no pain or discomfort. You can eat and drink normally before the appointment — there is no special preparation.

After the test, the radiologist reviews the images and sends a report to your doctor. Your doctor will contact you with the results, usually within a few days. If the screening finds no aneurysm, you are done — you have used your one lifetime screening. If an aneurysm is found, your doctor will discuss next steps, which may include follow-up imaging or referral to a vascular surgeon.

Billing and what you will receive

The imaging center will bill Medicare directly using the G0180 code. If you meet the coverage criteria, Medicare pays the facility, and you owe nothing. You will receive an Explanation of Benefits (EOB) in the mail from Medicare showing that the claim was processed and paid. Keep this document for your records.

If Medicare denies the claim because you do not meet the age, smoking, or family history requirements, the imaging center will send you a bill for the full cost of the test. At that point, you can appeal the denial if you believe Medicare made an error, or you can pay the bill. If you choose to appeal, contact Medicare at 1-800-MEDICARE and ask for a reconsideration.

What to do if Medicare denies the claim

If you receive a denial notice, read it carefully to see why Medicare said no. Common reasons include: you do not meet the age requirement, you have no documented smoking history, you have no family history of AAA, or the facility was not Medicare-approved. Some denials are mistakes — for example, if your smoking history was not in your medical record when Medicare reviewed the claim.

You have the right to appeal. Call Medicare at 1-800-MEDICARE and explain why you believe the denial was wrong. If you have a family history of AAA, bring documentation (such as a letter from a family member's doctor or a death certificate noting AAA). If you are a former smoker, ask your doctor to add a note to your medical record stating your smoking history, then ask the imaging center to resubmit the claim. Appeals can take several weeks, but Medicare will reconsider.

Frequently Asked Questions

Can I get the G0180 screening more than once?

No. Medicare covers this screening once in your lifetime. If you had it done before, you are not may be able to access for another one, even if you meet all the other requirements. If you need follow-up imaging because an aneurysm was found, that is a different code and may be covered separately.

What if I am a woman — can I get this screening?

Medicare does not routinely cover G0180 for women. However, if you have a documented family history of abdominal aortic aneurysm, you may be covered. Talk to your doctor about whether your family history qualifies you. You will need written proof of the family history in your medical record.

Do I need a referral from my primary care doctor?

You do not need a formal referral, but your primary care doctor or another physician must order the test. You cannot walk into an imaging center and request G0180 on your own. Medicare requires a doctor's order to pay for the screening.

What if the imaging center says they are not sure if they are Medicare-approved for G0180?

Ask them to check their Medicare provider status or call Medicare at 1-800-MEDICARE to confirm. Do not have the test done until you know for certain the facility is approved — if they are not, you will be stuck with the bill. Your doctor's office can also make this call on your behalf.

Will my Medigap or Medicare Advantage plan cover G0180 if Medicare does not?

Probably not. Medigap and Medicare Advantage plans follow Medicare's coverage rules for screening tests. If Medicare says you do not meet the criteria, your supplemental plan will not pay either. However, it is worth calling your plan to ask, since some plans have slightly different rules.