How often will Medicare pay for a bone density test?

Medicare Part B covers bone mass measurement once every 24 months for people who meet at least one of the five qualifying conditions. It can be covered more often if your doctor documents that more frequent testing is medically necessary. Testing requested earlier without a documented medical reason may not be covered.

Do I have to pay anything for a Medicare-covered bone density test?

You pay nothing for the test if the doctor or other health care provider accepts assignment, meaning they agree to accept the Medicare-approved amount as payment in full. If the provider does not accept assignment, your share may be higher. Ask the office directly how much the test will cost you before scheduling.

Does Medicare cover a bone density test if I have no symptoms?

Medicare covers bone mass measurement only when you meet one or more of its five listed conditions, which are based on medical history, X-ray findings, medications, a hyperparathyroidism diagnosis, or monitoring of osteoporosis drug therapy. Having no symptoms does not by itself disqualify you, since several conditions involve risk rather than symptoms. Your doctor determines and documents which condition applies.

Does Medicare Part B cover osteoporosis medications?

Medicare lists injectable osteoporosis drugs among the outpatient drugs that Part B can cover, under its own coverage rules. Most medications you take by mouth fall under Part D instead. Check Medicare.gov or call 1-800-MEDICARE to confirm how a specific drug is covered.

Does a Medicare Advantage plan cover bone density testing?

Medicare Advantage plans are required to cover everything Original Medicare covers, which includes bone mass measurement. Costs, networks and referral rules differ from plan to plan. Read your plan's Evidence of Coverage or call the plan before you schedule the test.

Does Medicare Cover a Bone Density Test?

Yes — Medicare Part B covers bone mass measurements, the test most people know as a bone density test or DEXA scan. Medicare pays for it once every 24 months, or more often if it is medically necessary, as long as you meet at least one of five conditions. If your doctor or other provider accepts assignment (agrees to accept the Medicare-approved amount as full payment), you pay nothing for the test itself. And while the first qualifying condition applies only to women, the other four apply to men too.

The Detailed Answer

Medicare treats bone mass measurement as a preventive service under Part B (Medical Insurance). According to Medicare.gov, the test “helps to find out if you’re at risk for broken bones,” and the results help you and your doctor choose the best way to keep your bones strong.

Two things decide whether Medicare pays: whether you meet one of the listed conditions, and how recently you had the test.

The five conditions that qualify you

Medicare covers the test if you meet one or more of these conditions, as the program states them:

You’re a woman whose doctor determines you’re estrogen-deficient and at risk for osteoporosis, based on your medical history and other findings.
Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures.
You’re taking prednisone or steroid-type drugs, or are planning to begin this treatment.
You’ve been diagnosed with primary hyperparathyroidism.
You’re being monitored to see if your osteoporosis drug therapy is working.

You only need to meet one. Your doctor documents which condition applies when ordering the test.

Does Medicare cover a bone density test for men?

It can. The first condition on Medicare’s list is written specifically for women — estrogen deficiency with a risk of osteoporosis. The other four are not limited by sex. A man whose X-rays suggest osteopenia or a vertebral fracture, who is starting prednisone or another steroid-type drug, who has been diagnosed with primary hyperparathyroidism, or who is being monitored on osteoporosis drug therapy meets Medicare’s eligibility the same way a woman would.

Medicare does not list any additional conditions for men, and this page does not add any. Ask your doctor whether one of the five applies to you.

How often Medicare pays for the test

Once every 24 months. Medicare will cover it more often than that if it is medically necessary — meaning your doctor documents a clinical reason you need repeat testing sooner, such as watching how a bone-building medication is working.

If you ask for a scan earlier than Medicare allows and there’s no documented medical need, you may be responsible for the cost. Medicare notes plainly that a doctor may recommend services the program doesn’t cover, or offers more frequently than Medicare pays for, and that this can lead to extra costs for you.

What you pay

You pay nothing for this test if the doctor or other health care provider accepts assignment — that is, agrees to accept the Medicare-approved amount as payment in full. Because bone mass measurement is a covered preventive service, the yearly Part B deductible and the usual 20% coinsurance don’t apply in that situation.

If a provider does not accept assignment, your share can be higher. It’s reasonable to ask the office two questions before you go: do you accept assignment, and how much will this test cost me? Medicare publishes current Part B premium and deductible amounts, which change every year, at Medicare.gov’s costs page.

One more Part B note: Medicare lists injectable osteoporosis drugs among the outpatient drugs Part B can cover, under its own rules.

If you have a Medicare Advantage plan

Medicare Advantage plans must cover everything Original Medicare covers, including bone mass measurement. Anything beyond that — and the network rules, referral requirements, or cost-sharing that apply — varies by plan. Check your plan’s Evidence of Coverage document or call the plan directly before scheduling.

Is a DEXA scan the same thing as a bone density test?

In everyday use, yes. “DEXA scan” is the name of the most common technology used to measure bone mass, and Medicare’s own term for the covered benefit is “bone mass measurements.” When your doctor orders a bone density scan or a bone density screening, that’s the service Medicare’s Part B preventive benefit refers to.

What can I do to protect my bones between tests?

Weight-bearing and resistance exercise is one of the better-studied levers you have, and it doesn’t require a prescription. Our guide to the best exercises for bone density after 50 walks through what the research supports and how to start safely. For the broader picture — risk factors, medications, fall-proofing — see how to prevent osteoporosis after 50.

Does Medicare cover calcium or vitamin D supplements?

Original Medicare generally does not pay for over-the-counter vitamins and minerals taken by mouth, so most people buy calcium and vitamin D out of pocket. What matters more is whether you need them and at what dose — our overview of calcium and vitamin D for bone health after 50 covers the evidence and the amounts commonly recommended. Talk with your doctor or pharmacist before adding either, especially if you take other medications.

What if my results show osteopenia or osteoporosis?

A result showing possible osteoporosis, osteopenia, or vertebral fractures is itself one of Medicare’s five qualifying conditions, so follow-up testing is generally covered on the usual schedule. Your doctor may also begin drug therapy, and monitoring to see whether that therapy is working is another qualifying condition. Discuss the specific plan — and the timing of your next scan — with the provider who ordered the test.

Where to Get Official Answers

Coverage questions are easier to settle at the source than secondhand. Three places give free, official answers:

Medicare.gov — the program’s own coverage pages, including the bone mass measurements page.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048 — available 24 hours a day, 7 days a week (except some federal holidays).
Your State Health Insurance Assistance Program (SHIP) — free, personalized counseling in your state. Contact information is at Medicare.gov’s talk-to-someone page.

Because this test needs a doctor’s order and coverage can depend on medical necessity, also consult your doctor about whether a bone density test is medically necessary for you right now, which of the five conditions applies, and when you should be tested again. Your pharmacist is a good second stop if you take prednisone, a steroid-type drug, or an osteoporosis medication and want to understand how it affects your bones.

Sources:

Bone mass measurements — Medicare.gov — Part B coverage, the five eligibility conditions, once-every-24-months frequency, and the $0 cost when the provider accepts assignment.
Prescription drugs (outpatient) — Medicare.gov — Lists injectable osteoporosis drugs among outpatient drugs Part B can cover.
Medicare costs — Medicare.gov — Where readers can check the current-year Part B premium and deductible, which change annually.
Talk to someone — Medicare.gov — 1-800-MEDICARE phone and TTY numbers and State Health Insurance Assistance Program (SHIP) counseling.