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

Medicare Part B pays for a DEXA scan (dual-energy x-ray absorptiometry) if your doctor writes an order and you meet specific medical criteria. The scan measures bone density and helps detect osteoporosis before a fracture happens. Medicare covers the test itself, but you pay your share of the cost — typically 20 percent of the approved amount after you have met your Part B deductible for the year.

The scan is usually done at a hospital outpatient department, imaging center, or doctor's office that accepts Medicare. You do not need to be admitted to a hospital. The procedure takes 10 to 30 minutes and involves lying still while a scanner passes over your spine, hip, and sometimes forearm.

Key Takeaways

Your doctor must order the DEXA scan for it to be covered — Medicare does not cover scans done for screening alone without a medical reason.
You pay 20 percent coinsurance after your Part B deductible, so the actual cost depends on what Medicare's approved amount is in your area.
Medicare covers one DEXA scan every 24 months for most people, though more frequent scans may be covered if you are being treated for osteoporosis or taking certain medications.
The facility must be enrolled in Medicare and the technician must be certified for the scan to be covered.

Who qualifies for Medicare coverage of a DEXA scan

Medicare covers a DEXA scan if you are a woman age 65 or older, or a man age 70 or older, and your doctor thinks you may have bone loss. You may also may have access to at a younger age if you have risk factors for osteoporosis — such as taking corticosteroids long-term, having rheumatoid arthritis, or having a personal or family history of fractures.

Your doctor must document the medical reason for the scan in your chart. Medicare does not cover DEXA scans ordered just to check bone density without a clinical reason. The ordering provider must be enrolled in Medicare and authorized to order imaging tests.

If you have already had a DEXA scan covered by Medicare, the next one is usually covered no sooner than 24 months later, unless you are being treated for osteoporosis or your doctor has a specific reason to repeat it sooner.

What you pay out of pocket

Your cost for a DEXA scan depends on two things: whether you have met your Part B deductible for the year, and what Medicare's approved amount is in your area. The approved amount varies by location and facility.

If you have not met your Part B deductible (which is $240 in 2024, though this amount changes yearly), you pay the full approved amount until the deductible is satisfied. Once you have met it, you pay 20 percent of the approved amount. If the facility charges more than Medicare's approved amount, you may owe the difference as well — though most Medicare-enrolled facilities agree not to balance-bill.

If you have a Medigap or Medicare Advantage plan, your out-of-pocket cost may be lower. Medigap plans often cover the 20 percent coinsurance. Medicare Advantage plans have their own cost-sharing rules, which vary by plan.

How to get a DEXA scan through Medicare

Start by talking to your primary care doctor or a bone specialist about whether a DEXA scan makes sense for you. If your doctor agrees, they will write an order for the scan. You do not need prior approval from Medicare, but some Medicare Advantage plans may require it — check your plan documents or call the number on your card.

Your doctor's office will usually help you find a Medicare-enrolled imaging center or hospital outpatient department near you. When you call to schedule, confirm that the facility accepts Medicare and ask about your expected out-of-pocket cost. Bring your Medicare card and any other insurance cards to your appointment.

On the day of the scan, wear loose, comfortable clothing without metal buttons, zippers, or snaps. The technician will position you on the scanner table and take images. You will receive results within a few days, usually sent to your doctor first.

What the results mean and next steps

A DEXA scan produces a T-score, which compares your bone density to that of a healthy young adult. A T-score of -1 or higher is considered normal. A score between -1 and -2.5 indicates low bone mass (osteopenia). A score below -2.5 means osteoporosis.

Your doctor will discuss the results with you and explain what they mean for your health. If you have low bone mass or osteoporosis, your doctor may recommend lifestyle changes, vitamin D and calcium, or medications to slow bone loss. Medicare covers many of these treatments as well.

If your scan shows normal bone density, your doctor will tell you when or whether you need another scan. For most people without bone loss, the next DEXA scan would not be covered sooner than 24 months.

DEXA scans and Medicare Advantage plans

Medicare Advantage plans must cover DEXA scans at the same rate as Original Medicare, but they may have different rules about where you can go and whether you need prior approval. Some plans require you to use in-network imaging centers, while others allow any Medicare-enrolled facility.

Check your plan's coverage documents or call the number on your card before scheduling. Ask whether the specific facility your doctor recommends is in-network and whether prior approval is needed. If prior approval is required and you do not get it, you may be responsible for the full cost.

Frequently Asked Questions

Can I get a DEXA scan if I am under 65?

Yes, if your doctor has a medical reason to order one. Medicare covers DEXA scans for younger people who take corticosteroids long-term, have rheumatoid arthritis, have had a fracture, or have other risk factors for bone loss. Your doctor must document the reason in your medical record.

How often does Medicare cover DEXA scans?

Medicare covers one DEXA scan every 24 months for most people. If you are being treated for osteoporosis with medication, your doctor may order more frequent scans to monitor your response to treatment, and Medicare may cover these if medically necessary.

What if my doctor orders a DEXA scan and Medicare denies it?

If Medicare denies coverage, you have the right to appeal. Your doctor's office can help you file an appeal and provide documentation of the medical reason for the scan. You can also contact Medicare directly at 1-800-MEDICARE to ask why the claim was denied.

Does Medicare cover DEXA scans at home or through a mobile unit?

Medicare covers DEXA scans performed at Medicare-enrolled facilities, which include hospitals, imaging centers, and some doctor's offices. Mobile units and home-based scans are generally not covered unless they are operated by a Medicare-enrolled provider.

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

Most Medigap plans cover the 20 percent coinsurance for Part B services, including DEXA scans. Check your plan documents or call your Medigap insurer to confirm your coverage before your appointment.

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.