Does Medicare Cover a Bone Density Test?

As much as we may try to fight it, as we grow older our bodies become weaker. Especially our bones and joints.

That is big reason why so many seniors are prone to conditions such as osteoarthritis and osteoporosis. The good thing is you can undergo bone density tests to see exactly what’s going on inside your bones. This can help you understand your risks and work with your doctor to treat any issues.

So a common question many people have is, “Does Medicare cover a bone density test?” In this article, we answer that question in clear, plain English. You will also find the average costs of bone density tests and other helpful info.

Does Medicare Cover a Bone Density Test?

The short answer is yes; Medicare will cover the cost of bone density tests. But not 100% of the time. As is often the case with Medicare, certain conditions must be met in order for Medicare to pay for your bone density test. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for bone density tests. Medicare Part A may provide coverage for a bone scan if it is part of an inpatient stay.

However, most of the time, it is Medicare Part B that provides coverage for bone density tests. This is because they usually take place in an outpatient setting.

Medicare Part B typically provides coverage for a bone density test once every 2 years. However, if you have a specific condition that requires more frequent bone scans, Medicare Part B may cover those too.

For Medicare Part B to provide coverage for your bone density test, certain conditions must be met. These include:

Your healthcare provider orders the bone scan for a medically necessary reason

It has been 23 months since your last bone scan or you have a condition that requires more frequent bone scans. Some of these conditions may include:
- Rheumatoid arthritis
- Diabetes
- Chronic kidney disease
- Organ transplant
- Overactive parathyroid gland and other hormonal imbalances
The outpatient facility where the bone scan will take place accepts Medicare

Additionally, for Medicare to fully cover your bone density test, you will have to meet the following conditions:

You are at high risks for the following conditions:
- Osteoporosis
- Osteopenia
- Injury
You are taking medications for osteoporosis and your healthcare provider needs to check your progress
You have an estrogen deficiency

If you meet all these conditions, Medicare Part B will cover 100 percent of the costs of your bone scans.

Part C Coverage for Bone Density Tests

Medicare Advantage plans (Medicare Part C) also provide coverage for bone density scans. They cover everything Original Medicare covers as well as offer some additional benefits. However, exactly what they cover and how much the out-of-pocket costs are will vary depending on the specifics of your plan.

How Much Does It Cost To Get A Bone Density Test?

For those without health insurance, bone density screenings usually cost between $150 and $250. This includes both the test and the doctor’s consultation to go over the results with you.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.