What Medicare Covers for DEXA Scans and Bone Density Testing

Medicare Part B covers DEXA scans when your doctor orders one to check for osteoporosis or monitor bone loss, but only if you meet specific medical criteria

A DEXA scan (dual-energy X-ray absorptiometry) is an imaging test that measures bone density. Medicare Part B pays for the scan itself — typically 80 percent of the approved amount after you meet your deductible — when a doctor documents that you need it for medical reasons. The remaining 20 percent is your responsibility unless you have a Medigap or Medicare Advantage plan that covers it.

The catch is that Medicare does not pay for routine screening in everyone. The test must be ordered by a physician, and the reason for ordering it matters. Medicare will cover a DEXA scan if you are a woman age 65 or older, a man age 70 or older, or a younger person with specific risk factors for bone loss — such as a prior fracture, long-term corticosteroid use, or certain medical conditions that weaken bone.

If you have already had a DEXA scan, Medicare limits how often it will pay for another one. Typically, coverage is available once every 24 months, though more frequent scans may be covered if your doctor documents medical necessity — for instance, if you are starting a new osteoporosis treatment and need to monitor its effect.

Key Takeaways

Medicare Part B covers DEXA scans ordered by a doctor when you meet age or risk-factor criteria, paying 80 percent of the approved amount after your deductible.
You must be age 65 or older (women) or 70 or older (men), or have documented risk factors such as prior fracture or corticosteroid use, for Medicare to cover the scan.
Medicare typically covers one DEXA scan every 24 months, though your doctor can request coverage more often if medically necessary.
Your doctor must order the scan and document the medical reason; you cannot request one on your own and expect Medicare to pay.
The 20 percent you owe out of pocket may be covered by a Medigap plan or Medicare Advantage plan, depending on your coverage.

Who qualifies for Medicare coverage of DEXA scans

Medicare Part B covers DEXA scans for women age 65 and older and men age 70 and older without requiring any additional reason. If you fall into either age group and your doctor orders the scan, Medicare will pay its share.

Younger people can also get coverage if they have risk factors for bone loss. These include a prior fracture (especially of the hip, spine, or wrist), long-term use of corticosteroid medications such as prednisone, rheumatoid arthritis, chronic kidney or liver disease, or a family history of osteoporosis. Your doctor must document the reason in your medical record for Medicare to approve payment.

If you are a woman between ages 50 and 64 with risk factors, or a man between ages 50 and 69 with risk factors, you may also may have access to. The key is that a physician must identify and record the risk factor before ordering the scan.

What you pay out of pocket

Once Medicare approves the scan, you pay 20 percent of the Medicare-approved amount after you have met your Part B deductible for the year. The deductible amount changes yearly; for 2024 it is $240, though this figure may differ in future years.

The actual cost you owe depends on what the facility charges and what Medicare approves. A DEXA scan typically costs between $100 and $300 at the facility level, but Medicare's approved amount is often lower. If the facility is in-network with Medicare, they must accept Medicare's approved amount as payment in full (except for your 20 percent share). Out-of-network facilities may bill you for the difference, though this is uncommon for DEXA scans.

If you have a Medigap plan, it may cover some or all of your 20 percent coinsurance, depending on which plan you hold. If you have a Medicare Advantage plan, your out-of-pocket cost may be different — some plans charge a copay instead of coinsurance, and some waive the cost entirely. Check your plan documents or call your plan to learn what you will owe.

How often Medicare pays for repeat scans

Medicare covers one DEXA scan every 24 months (once every two years). If your doctor orders a second scan within that window, Medicare will deny payment unless your doctor submits documentation of medical necessity.

Medical necessity might include starting a new osteoporosis treatment and needing to measure response, a significant change in your health that affects bone density, or a new fracture. Your doctor must write a letter or note explaining why the scan cannot wait until the 24-month window closes. Medicare will review the request, and approval is not may provide — it depends on whether the reason meets Medicare's standards.

If Medicare denies a scan your doctor ordered, you have the right to appeal. Your doctor's office can file the appeal on your behalf, or you can contact Medicare directly at 1-800-MEDICARE to request a review.

Where to get a DEXA scan covered by Medicare

You can have a DEXA scan at a hospital, imaging center, or bone density clinic. The facility must be enrolled in Medicare for the scan to be covered. Most major hospitals and imaging centers are Medicare-enrolled, but smaller or private facilities may not be.

Before scheduling, ask your doctor's office to confirm that the facility accepts Medicare. You can also search the Medicare provider directory online at Medicare.gov or call 1-800-MEDICARE to verify. If you go to a non-Medicare facility, you will likely owe the full cost yourself.

Some facilities offer DEXA scans at lower cost through community health programs or research studies. If cost is a concern, ask your doctor whether such options exist in your area, though these scans may not be covered by Medicare.

The difference between screening and diagnostic DEXA scans

Medicare distinguishes between a screening DEXA scan (done to check for bone loss in someone without symptoms) and a diagnostic DEXA scan (done because you have symptoms or a known condition affecting bone). This distinction affects coverage.

A screening scan is covered for women 65 and older and men 70 and older, as described above. A diagnostic scan — ordered because you have had a fracture, have osteoporosis, or have a condition known to weaken bone — may be covered more frequently than the standard 24-month window. Your doctor must use the correct code when ordering the scan so that Medicare processes it as diagnostic rather than screening.

If your doctor orders a scan and Medicare denies it as not medically necessary, ask whether the denial was because it was coded as screening rather than diagnostic. Coding errors do happen, and your doctor's office can resubmit with the correct code.

What to do if Medicare denies your DEXA scan

If Medicare denies payment for a DEXA scan, you will receive a notice called a Explanation of Benefits (EOB) in the mail. The EOB explains the reason for the denial — for example, "not medically necessary" or "frequency limit exceeded."

Read the denial reason carefully. If you believe it is wrong, you can appeal. The appeal process has several levels: you can ask for reconsideration by Medicare, then request a hearing before a Medicare contractor, and ultimately appeal to an administrative law judge. Your doctor's office can help by submitting additional medical records or a letter of medical necessity.

If you cannot afford to wait for an appeal, you have the right to ask the facility not to bill you while the appeal is pending. Do not pay the bill until the appeal is resolved, unless you choose to do so. If you pay and then win the appeal, you can request a refund.

Frequently Asked Questions

Does Medicare cover DEXA scans for men under 70?

Yes, if your doctor documents risk factors for bone loss such as a prior fracture, corticosteroid use, or a condition affecting bone density. The age requirement of 70 applies only to men without documented risk factors. If you are younger and have risk factors, ask your doctor to note them in your medical record before ordering the scan.

What if I want a DEXA scan but my doctor says it is not necessary?

You cannot have Medicare pay for a scan your doctor does not order. If you are concerned about bone health, discuss your concerns with your doctor and ask whether you have risk factors that would warrant a scan. Your doctor is the only one who can order it and document medical necessity for Medicare.

Will my Medigap plan cover the 20 percent I owe for a DEXA scan?

It depends on which Medigap plan you have. Plans C, D, G, and M cover coinsurance; Plans A, B, and F cover some or all of it. Check your plan documents or call your Medigap insurer to confirm. Medicare Advantage plans vary widely, so contact your plan directly.

Can I get a DEXA scan at a private imaging center and have Medicare pay?

Only if the center is enrolled in Medicare. Call the center before scheduling and ask whether they accept Medicare. You can also verify enrollment at Medicare.gov or by calling 1-800-MEDICARE. Non-enrolled facilities will not be covered.

What happens if I need a DEXA scan before 24 months have passed since my last one?

Your doctor can request an exception by submitting a letter explaining medical necessity — for example, if you started a new osteoporosis treatment and need to measure its effect. Medicare will review the request. Approval is not automatic, but it is possible if the reason is strong enough.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.