Medicare Part B pays for doctor visits, lab tests, imaging, outpatient surgery, and preventive care at no charge beyond your monthly premium and annual deductible

Medicare Part B is your coverage for services you receive outside a hospital stay — mainly visits to doctors' offices, urgent care centers, and outpatient clinics. It covers the cost of the visit itself, diagnostic tests like blood work and X-rays, and procedures done in an office or outpatient surgery center. You pay a monthly premium (the amount changes each year based on your income), and after you meet your annual deductible, Medicare pays 80 percent of approved charges. You pay the remaining 20 percent.

Part B also covers preventive services at no cost to you — annual wellness visits, cancer screenings, vaccines, and heart disease checks — even before you meet your deductible. This means you can see your doctor for a checkup or get a mammogram without paying anything out of pocket for that specific service.

Key Takeaways

  • Part B covers doctor office visits, lab tests, X-rays, ultrasounds, and outpatient procedures after you meet your annual deductible.
  • Preventive services like annual wellness visits, cancer screenings, and vaccines are covered at no cost, even before you meet your deductible.
  • You pay a monthly premium regardless of whether you use services, plus 20 percent of approved charges after your deductible.
  • Part B does not cover hospital stays (that is Part A), prescription drugs (that is Part D), or long-term care at home or in a facility.

Doctor Visits and Office-Based Care

Part B covers visits to your primary care doctor, specialists, and other licensed practitioners like nurse practitioners and physician assistants. This includes routine checkups, sick visits, and follow-up appointments for chronic conditions like diabetes or heart disease. The visit itself is covered; you pay your share of the bill after your deductible is met.

Part B also covers mental health services — therapy and psychiatric visits — at the same rate as physical health visits. This means you pay 20 percent of the approved amount after your deductible. If you see a therapist or psychiatrist who accepts Medicare, you will not face a separate deductible for mental health the way you might have under older insurance plans.

Telehealth visits — appointments by video or phone with your doctor — are covered under Part B the same way in-person visits are. This expanded coverage has remained in place since the pandemic, so you can use telehealth for many routine concerns without traveling to an office.

Diagnostic Tests and Imaging

Part B covers lab work ordered by your doctor: blood tests, urinalysis, and other diagnostic tests performed in a lab or doctor's office. It also covers imaging services — X-rays, CT scans, ultrasounds, and MRI scans — when your doctor orders them to diagnose or monitor a condition. After your deductible, you pay 20 percent of the approved charge for these services.

Preventive screening tests are covered at no cost. This includes colonoscopies for colorectal cancer screening, mammograms for breast cancer, bone density scans for osteoporosis, and cardiovascular screening tests. You do not pay anything for these preventive tests, even if you have not yet met your deductible for the year.

Outpatient Surgery and Procedures

Part B covers surgery and procedures performed in an outpatient setting — meaning you go home the same day rather than staying overnight. This includes minor surgical procedures in a doctor's office, procedures at an ambulatory surgery center, and outpatient procedures at a hospital. After your deductible, you pay 20 percent of the approved cost.

Examples include cataract removal, joint injections, skin biopsies, and many orthopedic procedures. If your doctor recommends a procedure, ask whether it will be done as an outpatient (covered by Part B) or whether you will need to stay overnight (covered by Part A instead).

Preventive Services at No Cost

Medicare Part B covers a specific list of preventive services with no copay or coinsurance, even before you meet your deductible. These include an annual wellness visit with your doctor, during which you review your health history and discuss any concerns. The visit itself is free, though any tests or procedures ordered during that visit follow the normal deductible and coinsurance rules.

Covered preventive services also include cancer screenings (colorectal, breast, cervical, and prostate), cardiovascular screening, diabetes screening, bone density screening, and vaccines for flu, pneumonia, shingles, and COVID-19. You can receive these services at no cost as often as Medicare guidelines recommend, typically once per year or once every few years depending on the service.

What Part B Does Not Cover

Part B does not cover hospital stays — that is Part A. It does not cover prescription drugs — that is Part D. It does not cover dental care, vision care (eyeglasses or contact lenses), hearing aids, or routine foot care, though some limited foot care is covered if you have diabetes.

Part B does not cover long-term care at home (like a home health aide who helps with bathing or dressing) or care in a nursing home or assisted living facility. It does not cover routine physical exams for work or insurance purposes, or services related to work injuries covered by workers' compensation. If you need services not listed here, contact Medicare directly or ask your doctor whether a service is covered before you receive it.

How Your Costs Work Under Part B

Your Part B costs have three parts: the monthly premium, the annual deductible, and coinsurance. The premium is deducted from your Social Security check (or paid directly if you do not receive Social Security). The amount varies by year and by your income — higher earners pay a higher premium.

After you pay your annual deductible (the amount also varies by year), Medicare pays 80 percent of approved charges and you pay 20 percent. This 20 percent coinsurance continues for the rest of the calendar year. If you have a Medigap or Medicare Advantage plan, that plan may cover some or all of your deductible and coinsurance, depending on which plan you chose.

If your doctor does not accept Medicare assignment — meaning they do not agree to accept Medicare's approved amount as full payment — you may owe more than 20 percent. Before your appointment, ask whether your doctor accepts Medicare assignment to avoid surprise bills.

Frequently Asked Questions

Does Part B cover my annual physical exam?

Yes. Medicare Part B covers one annual wellness visit per year at no cost. During this visit, your doctor reviews your health history, takes your vital signs, and discusses preventive care. Any tests or procedures ordered during the visit are billed separately and follow normal deductible and coinsurance rules.

What if my doctor charges more than Medicare approves?

If your doctor accepts Medicare assignment, they can only charge you your share (20 percent after deductible) of Medicare's approved amount. If they do not accept assignment, they may charge up to 15 percent more than the approved amount. Ask your doctor's office before your visit whether they accept Medicare assignment.

Do I have to pay anything for preventive screenings like mammograms?

No. Preventive screenings covered by Medicare Part B — including mammograms, colonoscopies, and blood pressure checks — are covered at no cost to you. You do not pay a copay, coinsurance, or deductible for these services when performed as recommended by Medicare guidelines.

Does Part B cover physical therapy?

Yes. Part B covers physical therapy, occupational therapy, and speech-language pathology services when ordered by your doctor for a medical condition. After your deductible, you pay 20 percent of the approved charge. There is a yearly limit on how many therapy visits Medicare will pay for, though your doctor can request an exception.

What happens if I do not sign up for Part B when I first become may be able to access?

If you delay enrolling in Part B without a valid reason, you may face a permanent penalty that increases your monthly premium for life. The penalty is 10 percent of the standard premium for each full year you were may be able to access but not enrolled. Enroll during your initial enrollment period or during the General Enrollment Period (January 1 to March 31 each year) to avoid this penalty.