Your Medicare Coverage
Is my test, item, or service covered?
Diagnostic tests, X-rays, & clinical laboratory services
How often is it covered?
Medicare Part B (Medical Insurance) covers diagnostic non-laboratory tests, like CT scans, MRIs, EKGs, X-rays, and PET scans when your doctor or other health care provider orders them as part of treating a medical problem. Medicare also covers medically necessary clinical diagnostic laboratory tests ordered by your treating doctor or practitioner. These tests are done to help your doctor diagnose or rule out a suspected illness or condition.
Medicare also covers some preventive services and screenings to help prevent, find, or manage a medical problem.
All people with Part B are covered.
Your costs in Original Medicare
- In a doctor's office or independent testing facility, you pay 20% of the Medicare-approved amount for covered diagnostic non-laboratory tests and X-rays. The Part B deductible applies.
- In a hospital outpatient setting, you pay a copayment for diagnostic non-laboratory tests, and X-rays.
- You generally pay nothing for Medicare-covered clinical diagnostic laboratory tests.
To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.