Does Medicare Cover a Dexa Scan?

By Medicare Benefits - October 19, 2020

Even if you commit to exercising and making good diet choices, sometimes bone density can weaken as we age. This is very true if you're a woman who went through menopause, but diseases like cancer and other medical conditions, can have a negative impact on your bone health. Doctors can use a standard x-ray to get a diagnosis after an injury or examine your bone health, but a DEXA scan is more in-depth. DEXA stands for dual-energy x-ray absorptiometry. It can help pinpoint bone issues to help you get precision treatment, but does Medicare cover this scan?

Defining the DEXA scan

DEXA scan technology uses two different energy beams to take a close look at your bone density. It works to filter out any soft tissue during the imaging process, and this allows your bones to fully absorb the beam's energy and varying levels. In turn, this gives your physician in-depth information regarding the mineral density in your bones. 

Along with pointing out weak spots in your bone density, this scan is also helpful for showing weak spots where your bones aren't healing after an injury. Using this scan allows your physicians to tailor your treatment plant to address any specific issues they find that are impacting your bone mineral density.

Medicare coverage and DEXA scans

Medicare Part B usually covers the costs associated with a DEXA scan. Part B is the branch of Medicare that provides coverage benefits for medically-necessary outpatient procedures to help treat an ongoing illness. Your primary care provider or a specialist will have order this scan, and some conditions require you to have other tests or try other treatments before Medicare covers this avenue. However, this is rare. 

The cost of a DEXA scan can range from $125 up to over $300. It depends on your location, the facility, and the setting where you have the scan. Your deductible will apply, and you'll have to cover 20% of the cost yourself if you don't have a supplement to help pick up the leftover charge. 

Skilled Nursing Facility DEXA scans and Part A

Along with using Part B to pay for your DEXA scan in an outpatient setting, Part A could pay for it if you get your scan when you're in a required stay at a skilled nursing facility. This is very common if you're staying in this facility to get rehabilitation services to help you recover from an injury. It's also common to stay in these facilities if you need more comprehensive care than you can get on your own, or if you're recuperating from a cancer treatment operation as long as your bone density has gone down due to treatment or the disease itself.  

Medicare Part D and prescriptions

Depending on the results of your DEXA scan, your doctor may recommend that you start taking a medication or two to help improve your bone's overall health. If this is true for you, Part D could help pick up the cost of the prescription drugs you need. You do have to remember that it doesn't cover every prescription medication, so you want to double-check before you start anything new.  

Part D will also only cover the cost of medications that come from a retail pharmacy that you pick up to take at home. If your doctor orders a medication that you can't take at home or an injection, you'll typically have coverage through Part B because you receive this non-oral medication in an outpatient clinic setting. 

Bottom Line

It's a good idea to check with your Medicare coverage and see if it'll pay for the majority of a DEXA scan. Medicare Advantage plans will vary in their coverage options and deductibles, so you should check with your insurance provider before you have any scans.

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