Does Medicare Cover CT Scans?
Short for “computed tomography,” CT scans are a diagnostic imaging tool used to get detailed images of soft tissue, bones, and blood vessels.
Medicare considers CT scans a diagnostic, “non-laboratory” test. Medicare helps cover some costs of the scans if your doctor recommends them for you. If you are at high risk for developing lung cancer, Medicare will fully cover CT scans once a year as a preventive service.
Key takeaways:
Medicare covers a CT scan if your doctor needs the test to treat or diagnose a condition.
You’ll pay 20% of the Medicare-approved cost for a CT scan after you meet your Part B deductible.
Medicare fully covers the cost of a CT scan once a year if you meet certain conditions for a lung cancer screening.
What is a CT scan?
CT scans provide in-depth images of different parts of your body. They use specialized equipment to take and combine multiple X-rays and create detailed cross-sectional pictures. During a CT scan, a machine revolves around you and takes multiple images from different angles. Sometimes these images are used to create 3D images, allowing for even greater detail.
When do you need a CT scan?
Compared to plain X-rays, CT scans are much more detailed. Doctors typically order CT scans when they need to examine internal injuries, tumors, blood clots, and infections. You may also need a CT scan if you need to monitor effectiveness of a treatment. Doctors also sometimes use CT scans to provide guidance during a biopsy or other minimally invasive procedure.
Does Medicare cover CT scans?
Yes, Medicare Part B covers CT scans if they’re medically necessary to treat or diagnose a medical issue. However, you’re still responsible for certain out-of-pocket costs. Your out-of-pocket costs for a CT scan depend on where you receive the test.
If you receive the CT scan at your doctor’s office or other outpatient facility, you’ll pay 20% of the cost of the service after you meet your Part B deductible. If you receive the CT scan at a hospital’s outpatient department, you’ll pay a hospital copayment on top of the 20% coinsurance. A Medicare Supplement plan will offset these out-of-pocket costs.
Other diagnostic non-laboratory tests that Medicare covers include:
If you have a Medicare Advantage plan, your out-of-pocket costs will vary depending on your plan. Contact your insurance company or check your summary of benefits to see what you can expect to pay.
Does Medicare cover CT scans for lung cancer?
Your doctor can also recommend a CT scan for screening purposes. CT scans are commonly used to screen for lung cancer, especially among people with a high risk for developing the condition. Like many preventive screenings, Medicare pays the full cost of the test if you meet all of the following criteria:
You are between the ages of 50 and 77
You don’t show signs or symptoms of lung cancer
You’re either a current smoker or you only stopped smoking within the last 15 years
You’ve smoked an average of one pack, or 20 cigarettes, per day for 20 years
Your doctor orders the screening
Still have questions about your Medicare costs? Get answers from a licensed Medicare Advisor who can break down your plan simply—call us at 855-900-2427 or schedule a time to chat.