Will Medicare pay for CT scans?
Does Medicare cover CT scans? Medicare will cover CT scans as long as they are medically necessary and prescribed by a Medicare-approved doctor. CT scans are commonly used to diagnose injuries and illnesses. Medicare will cover 80% of the Medicare-approved CT scan cost as long as you have met your deductible. See what other services Medicare covers
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- Medicare will generally cover CT scans as long as they are medically necessary and prescribed by a Medicare-approved doctor
- You will be responsible for paying your Medicare deductible and coinsurance or copayment of 20% of the Medicare-approved cost of the CT scan
- Medicare will also cover other diagnostic tests, including X-rays, PET scans, EKGs, and more
Diagnostic testing is commonly used to diagnose injuries and illnesses. However, these tests can be expensive, especially if you don’t have insurance. Therefore, understanding your Medicare insurance coverage is essential.
Does Medicare cover CT scans? We’ve answered this question and more below.
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Does Medicare cover CT scans?
Medicare guidelines for CT scans state that the program covers medically-necessary diagnostic testing, which typically includes CT scans. How much does a CT scan cost with Medicare?
Medicare Part A will cover a CT scan that is ordered while you are staying in a hospital, skilled nursing facility, or another inpatient facility.
Medicare Part B will cover a CT scan if it is ordered by a doctor in an outpatient setting, such as a doctor’s office.
Medicare Advantage plans are required to cover everything that Original Medicare does, so your plan will also cover CT scans. However, if your MA plan has a network, you will need to choose an in-network facility to make sure you’re paying the least out of pocket.
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What is a CT scan?
A CT scan allows doctors to see inside your body by taking X-rays from many different angles and then compiling them into a 3D image.
CT scans can be used to diagnose internal injuries, tumors or cancer, heart and lung disease, blood clots, infections, and more.
CT scans are generally painless. However, you may need to use a contrast liquid, which highlights certain areas of the body to show up better on the imaging. The liquid may need to be swallowed, injected, or administered using an enema.
How much does a CT scan cost?
How much does a CT scan cost on Medicare? Even though Medicare will cover CT scans, many plans have some out-of-pocket expenses, such as a deductible, copayment, or coinsurance.
If the CT scan is being covered by Medicare Part A, you will need to pay the deductible of $1,484 (as of 2021). If you are hospitalized for more than 60 days, you will also have to pay a coinsurance fee.
If the CT scan is being covered by Medicare Part B, you will need to pay the deductible of $203 (as of 2021). After the deductible is paid, Medicare will then cover 80% of the Medicare-approved cost of the CT scan, so you will have to pay the remaining 20%.
If you have a Medicare Advantage plan, you will need to contact your plan provider to know what kind of expenses you will have to pay.
What other diagnostic tests does Medicare cover?
Medicare covers a variety of diagnostic testing. You may be able to receive tests like an MRI, ultrasound, X-rays, EKGs, PET scans, and others.
An MRI is similar to a CT scan, but it doesn’t use radiation. Instead, it uses magnets and a radio frequency to create images of the body. An ultrasound is noninvasive and uses sound waves to view some images of the body.
Regardless of the type of diagnostic testing your doctor thinks is best, you will likely have to pay your deductible amount and your coinsurance or copayment fees. Medicare will cover 80% of the Medicare-approved amount of the diagnostic testing.
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