Diagnostic non-laboratory tests
Medicare Part B (Medical Insurance) covers diagnostic non-laboratory tests.
Coverage details
Part B covers these tests when your provider orders them to find or treat a medical problem.
Costs
- After you meet the Part B deductible , you pay 20% of the Medicare-approved amount for covered diagnostic non-laboratory tests you get in your doctor’s office or in an independent diagnostic testing facility.
- If you get the test at a hospital as an outpatient, you also pay the hospital a copayment that may be more than 20% of the Medicare-approved amount. In most cases, this amount can't be more than the Part A hospital stay deductible.
- If you get certain diagnostic non-laboratory tests (advanced diagnostic imaging services CT, MRI, nuclear medicine, or PET scans) outside of a hospital, including from a provider, medical practice, clinic, or free-standing radiology center, check with the provider before you get your test to make sure they're accredited. Medicare will only pay for your test if you get it from an accredited provider. If Medicare doesn't pay for your test because the provider isn't accredited, the provider can't bill you for the test.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service