Bone mass measurements (also called bone density tests) can help determine if you need medical treatment for osteoporosis, a condition that can cause brittle bones in older adults.
Medicare Part B covers bone mass measurement every two years if you are at risk for osteoporosis and have a referral from your provider. Medicare considers you at risk if you:
- Are an estrogen-deficient women who is at risk for osteoporosis based on your medical history and other findings
- Have vertebral abnormalities that were shown on an x-ray
- Have received daily steroid treatments for more than three months
- Have hyperparathyroidism
- Receive osteoporosis drug therapy
Medicare will also cover follow-up measurements and/or more frequent screening if your doctor prescribes them.
If you qualify, Original Medicare covers bone mass measurements at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover bone mass measurements without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
During the course of your bone mass measurement, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.