Does Medicare Cover Chest X-rays?

Medicare provides benefits for many diagnostic services such as chest x-rays. In order to get coverage the testing and imaging services must be medically necessary in order to:

• diagnose a health condition
• monitor a health condition
• Treat an illness or health condition

Medicare Covers Many Diagnostic Services

Even with all of the innovation that has taken place in advanced medical imaging technology over the years, the humble and time-tested x-ray is still a crucial diagnostic tool when it comes to getting an inside look at the human body.

X-rays are used across a variety of medical specialties to diagnose everything from pneumonia to broken bones, and chest x-rays are among some of the most common types of x-rays taken today. In many cases, x-ray imaging will be ordered if a physician suspects a morphological change within the body, including when things like cancer cause tumors to appear within lung tissue.

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How Do X-rays Work?

X-rays utilize radiation at low levels that are directed toward parts of the body to be examined. In order for an x-ray image to be displayed, the part of the body being imaged will need to be placed in front of a detector that recognizes and translates the x-rays into light.

When an x-ray image is taken, dense areas will appear lighter while less dense areas will appear darker. When examined by a technician or specialist, abnormalities can be documented to aid in the treatment of injury or disease.

Does Medicare Cover Chest X-rays?

If your physician or specialist orders chest x-rays to be taken, you’ll likely have them completed in your doctor’s office or at an imaging center. Medicare recipients should be able to receive coverage for x-rays through Medicare Part B, the outpatient benefit.

Medicare x-ray coverage at a glance:

• Medicare Part B typically covers 80% of the cost of x-rays
• You are responsible for any deductibles
• You must cover any coinsurance costs

Although this coverage is fairly universal across all Medicare plans, it’s important to note that not all imaging centers are Medicare-approved, and some imaging technologies are not covered by Medicare. As a result, it’s always best to check with your Medicare plan manager prior to having x-rays taken to ensure that you will be covered.

If x-rays are taken as part of your treatment or monitoring while hospitalized or admitted to a skilled nursing facility, the cost will likely be covered by Medicare Part A, the inpatient benefit. If, however, specialists or equipment are brought in from outside of the facility, billing may occur separately under Medicare Part B for these services.

TIP: Find out which Medicare plans offer additional benefits including diagnostic and imaging services and compare them against your existing coverage.

Does Medicare Advantage Cover Chest X-rays?

If you have a Medicare Advantage plan, your coverage of x-ray imaging should meet at least the minimum coverage requirements as set forth by Original Medicare, meaning your chest x-rays should still be covered. With a Medicare Advantage plan, you may also be entitled to additional benefits that are unique to your plan and your plan provider.

These benefits may include the ability to seek diagnostic care through a wider network of providers, but you may also be able to receive advanced imaging at a discount in addition to your x-rays. Once again, your benefits are dependent upon your plan, so review your plan materials carefully to fully understand your benefits.

TIP: Discover the top 7 reasons to switch your Medicare Advantage plan.