What Medicare covers for dermatology
Medicare covers dermatology procedures when a doctor determines they are medically necessary — meaning they treat a disease or injury, not appearance. This includes removal of skin cancers, treatment of severe acne that affects function, removal of moles that bleed or change, and care for conditions like psoriasis or severe eczema. Medicare does not cover cosmetic procedures such as wrinkle removal, age spot treatment for appearance only, or hair removal.
The key distinction is medical necessity. A dermatologist must document in your chart that the procedure treats a diagnosed condition that affects your health or function. If the same procedure can be done for cosmetic reasons, Medicare will only pay if your doctor's notes show the medical reason. For example, removing a mole on your face is covered if it bleeds or shows signs of skin cancer, but not if you straightforward dislike how it looks.
Key Takeaways
- Medicare covers skin cancer removal, treatment of infections, and procedures for conditions like psoriasis or severe acne when medically necessary.
- Your dermatologist must document the medical reason for the procedure in your medical record for Medicare to pay.
- Cosmetic procedures — including wrinkle treatment, age spot removal for appearance, and hair removal — are never covered by Medicare.
- You typically pay 20 percent of the approved amount after you meet your Part B deductible, unless the procedure is done in a hospital outpatient setting.
- Some procedures may require prior authorization from Medicare before your appointment to confirm coverage.
Skin cancer removal and biopsies
Medicare covers the removal of skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma. This includes the biopsy (tissue sample) needed to diagnose the cancer and the surgical removal. The dermatologist may use excision (cutting out the growth), curettage and electrodesiccation (scraping and burning), cryotherapy (freezing), or Mohs micrographic surgery, which removes the cancer layer by layer while checking margins under a microscope.
Mohs surgery is covered when medically necessary, though it is more expensive than standard excision because it requires more time and informed. Medicare will pay for it if your dermatologist documents that the location or type of cancer makes it the appropriate choice — for instance, cancers on the face, ear, or eyelid where preserving healthy tissue matters. You will owe 20 percent coinsurance after your Part B deductible.
Treatment of skin infections and inflammatory conditions
Medicare covers treatment of bacterial, fungal, and viral skin infections when a doctor diagnoses them. This includes procedures like drainage of abscesses, removal of infected tissue, and treatment of severe cases of conditions like shingles or herpes zoster. Inflammatory skin conditions such as severe psoriasis, lichen planus, or severe eczema that require procedural treatment are also covered.
Phototherapy (light therapy) for psoriasis or other inflammatory conditions is covered when done in a medical setting under a doctor's supervision. Home phototherapy devices are not covered. If your dermatologist recommends injections or other procedures to treat these conditions, Medicare will cover them if they are medically necessary and your doctor documents the diagnosis and medical reason.
Removal of benign growths with medical reasons
Medicare covers removal of benign (non-cancerous) skin growths when there is a medical reason. A mole that bleeds, itches, changes size or color, or causes pain is medically necessary to remove. Warts that are painful, infected, or spreading may be covered. Seborrheic keratosis (age spots) are covered only if they are irritated, bleeding, or causing skin breakdown — not for appearance.
Skin tags are small, benign growths that hang from the skin. Medicare covers their removal only if they are in a location where they are repeatedly irritated by clothing or rubbing, or if they are bleeding or infected. Removal for appearance alone is not covered. Your dermatologist must document the medical reason in your chart.
What Medicare does not cover
Medicare does not cover any procedure done primarily for cosmetic reasons. This includes Botox or other wrinkle treatments, dermal fillers, chemical peels for sun damage or age spots, laser resurfacing for wrinkles or scars, and microdermabrasion. Hair removal by laser or other methods is not covered. Acne treatment is covered only when the acne is severe enough to affect function or cause significant scarring; routine acne care by a dermatologist is typically not covered.
Scar revision is not covered unless the scar is from an injury or surgery and is causing functional problems — for example, a scar that limits movement or causes pain. Scar revision done to improve appearance is cosmetic. Birthmark removal is covered only if the birthmark is causing medical problems, such as bleeding or infection, or if there is concern it may become cancerous.
How much you will pay
If your dermatology procedure is covered by Medicare Part B, you typically pay 20 percent of the Medicare-approved amount after you meet your annual Part B deductible. The deductible is the same amount each year (currently $240, though this changes annually). Once you meet it, you pay coinsurance on covered services for the rest of the year.
If the procedure is done in a hospital outpatient department rather than a private dermatology office, you may owe a copay instead of coinsurance, depending on your plan. If you have a Medigap or Medicare Advantage plan, your out-of-pocket cost may be lower because those plans help pay your coinsurance or copays. Ask your dermatologist's office what the Medicare-approved amount is for your procedure before your appointment so you know what to expect.
Prior authorization and what to ask your dermatologist
Some dermatology procedures require prior authorization — meaning your dermatologist must contact Medicare before the procedure to confirm it will be covered. This is more common for procedures that are sometimes done for cosmetic reasons, such as removal of benign growths or scar revision. Your dermatologist's office usually handles this request, but you should ask whether authorization is needed before your appointment.
Before your dermatology visit, ask your doctor these questions: Is this procedure covered by Medicare? Will you need to get prior authorization? What is the Medicare-approved amount, and what will I owe? If the procedure is not covered, what are my options? If your dermatologist recommends a procedure you are unsure about, ask them to explain the medical reason and whether Medicare will cover it. If they say it is cosmetic, Medicare will not pay.
Frequently Asked Questions
Does Medicare cover mole removal?
Medicare covers mole removal if there is a medical reason — the mole bleeds, itches, changes appearance, or causes pain. Removal of a mole solely because you dislike how it looks is cosmetic and not covered. Your dermatologist must document the medical reason in your chart.
Is acne treatment covered by Medicare?
Routine acne treatment is usually not covered. However, severe acne that causes significant scarring or affects function may be covered if your dermatologist documents the medical necessity. Procedures like chemical peels or laser treatment for acne scars are typically considered cosmetic and not covered.
What if my dermatologist says a procedure is medically necessary but Medicare denies it?
You have the right to appeal. Ask your dermatologist for a copy of the denial letter and the medical documentation they submitted. You can file an appeal with Medicare within 180 days. Your dermatologist's office can help you gather the information needed for the appeal.
Does Medicare cover laser treatment for age spots or sun damage?
No. Laser treatment for age spots, sun damage, or other signs of aging is considered cosmetic and is not covered by Medicare. Laser treatment is covered only for medical conditions such as severe acne, certain infections, or inflammatory skin diseases when medically necessary.
Will I owe anything if my procedure is covered?
Yes. You will owe 20 percent coinsurance after you meet your Part B deductible, unless the procedure is done in a hospital outpatient setting where you may owe a copay instead. Ask your dermatologist's office for the Medicare-approved amount before your appointment so you know your expected cost.