What Medicare Covers for Bone Density Testing

Medicare pays for bone density tests under specific conditions, and your out-of-pocket cost depends on which type of test you get and whether you meet the coverage rules

Medicare Part B covers bone density testing (also called a DXA scan or DEXA scan) when your doctor orders it for medical reasons. The program pays 80 percent of the approved amount after you meet your Part B deductible. You pay the remaining 20 percent, plus any difference between what the facility charges and what Medicare allows — though most facilities accept Medicare's approved amount.

The actual dollar amount you pay varies by location and facility. A bone density test typically costs between $100 and $300 before insurance, but Medicare's approved amount is usually lower. If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be different.

Key Takeaways

Medicare Part B covers bone density tests when medically necessary, paying 80 percent after your deductible is met.
You pay 20 percent coinsurance plus your Part B deductible, with the exact amount depending on your facility and location.
Your doctor must order the test for Medicare to cover it — you cannot request one on your own without a medical reason.
Medicare covers one bone density test every 24 months for most people, or more often if you have certain bone conditions or take specific medications.
Medigap plans typically cover your 20 percent coinsurance, while Medicare Advantage plans have their own cost-sharing rules.

When Medicare covers bone density testing

Medicare covers a bone density test when your doctor orders it to check for osteoporosis or monitor bone loss. The program has specific rules about who qualifies and how often you can have the test paid for.

You meet Medicare's coverage rules if you are a woman age 65 or older, a man age 70 or older, or anyone of any age with a medical condition that puts you at risk for bone loss — such as rheumatoid arthritis, chronic kidney disease, or a history of fractures. You also may have access to if you take certain medications long-term, particularly corticosteroids like prednisone.

Medicare covers one bone density test every 24 months for routine screening. If you have osteoporosis or are being treated for bone loss, your doctor may order more frequent tests, and Medicare will cover those if they are medically necessary.

What you pay out of pocket

Your costs depend on whether you have met your Part B deductible for the year. For 2024, the Part B deductible is $240. Once you meet it, you pay 20 percent of Medicare's approved amount for the bone density test.

If the facility charges more than Medicare's approved amount, you are responsible only for the 20 percent coinsurance on the approved amount — not on the facility's full charge. Most imaging centers and hospitals accept Medicare's approved rate, so your bill should be straightforward.

The actual coinsurance amount typically falls between $20 and $60, depending on your location and the facility. Ask the facility for an estimate before your test so you know what to expect.

How Medigap and Medicare Advantage plans affect your costs

If you have a Medigap plan, your coverage depends on which plan letter you chose. Most Medigap plans cover your 20 percent coinsurance for bone density tests, so you would pay little to nothing out of pocket after your Part B deductible. Some plans also cover the deductible itself.

If you have a Medicare Advantage plan, your costs work differently. Advantage plans set their own cost-sharing amounts for bone density tests — some charge a copay (a fixed amount like $25), while others charge coinsurance (a percentage). Check your plan's summary of benefits or call the plan directly to find out what you will owe.

Medicare Advantage plans must cover bone density tests at the same frequency as Original Medicare, but your out-of-pocket cost may be higher or lower than the 20 percent coinsurance you would pay under Part B.

How to get a bone density test through Medicare

Your doctor must order the test. You cannot request a bone density test on your own and have Medicare pay for it — there must be a medical reason documented in your chart.

Once your doctor orders it, you can have the test done at any facility that accepts Medicare: hospitals, imaging centers, bone health clinics, or your doctor's office if they have the equipment. Call ahead to confirm the facility accepts Medicare and ask about your out-of-pocket cost based on your specific plan.

Bring your Medicare card and any other insurance cards to your appointment. The facility will bill Medicare directly, and you will receive a bill for your coinsurance and deductible (if you have not met it yet).

Types of bone density tests Medicare covers

Medicare covers the DXA scan (dual-energy X-ray absorptiometry), which is the standard bone density test. It measures bone mineral density at your hip, spine, and sometimes forearm. The test takes about 10 to 30 minutes and uses very low radiation.

Medicare also covers bone density testing using other methods if medically necessary, such as quantitative ultrasound or CT scans, though these are less common for routine screening. Your doctor will decide which type of test is appropriate for your situation.

The DXA scan is painless, non-invasive, and requires no preparation. You lie on a table while the scanner passes over your bones. You do not need to undress, though you may be asked to remove metal objects.

What happens if you do not meet Medicare's coverage rules

If your doctor orders a bone density test but you do not meet Medicare's coverage criteria, Medicare will deny the claim. You would be responsible for the full cost of the test — typically $100 to $300 depending on the facility.

Some facilities offer self-pay discounts if you pay out of pocket. Ask about this option before your test. You can also ask your doctor whether the test is truly necessary or whether there are other ways to assess your bone health.

If Medicare denies coverage and you believe the denial is incorrect, you have the right to appeal. Your facility or doctor's office can help you file an appeal with Medicare.

Frequently Asked Questions

Do I need a referral from my doctor to get a bone density test?

Yes. Your doctor must order the test for Medicare to cover it. You cannot go directly to an imaging center and have Medicare pay. Your doctor will place the order, and you will schedule the appointment at a facility that accepts Medicare.

How often can Medicare pay for a bone density test?

Will my Medigap plan cover the 20 percent coinsurance?

Most Medigap plans cover your 20 percent coinsurance for bone density tests. The exact coverage depends on which plan letter you have. Call your Medigap insurer or check your plan documents to confirm what you will owe.

What if the imaging center charges more than Medicare allows?

You pay 20 percent coinsurance only on Medicare's approved amount, not on the facility's full charge. Most facilities accept Medicare's approved rate. Before your test, ask the facility whether they accept Medicare's approved amount so you know your exact cost.

Can I get a bone density test if I am under 65?

Yes, if you have a medical condition that puts you at risk for bone loss — such as rheumatoid arthritis, chronic kidney disease, or a history of fractures — or if you take medications like corticosteroids long-term. Your doctor must order the test and document the medical reason.

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.