Does Medicare cover bone density testing?

Doctor shows a woman a chart in a doctor’s office.

Yes, Medicare Part B (Medical insurance)  covers bone density testing, also referred to as bone mineral density (BMD) testing,  if you’re eligible and it’s medically necessary. In most cases, Medicare covers a bone density test when it’s used to help detect osteoporosis, measure bone mass loss or monitor treatment. A DEXA/DXA scan (Dual-Energy X-ray Absorptiometry) is one of the most common and accurate ways to check bone strength.1

Here’s a closer look at Medicare coverage for bone density testing.

Key points

  • Part B is the part of Original Medicare that typically covers bone density tests. 
  • A DEXA scan is the most used bone density test for osteoporosis screening.1
  • Medicare generally covers testing once every 24 months or more when medically necessary.
  • Some Humana Medicare Advantage plans (Part C) cover bone density tests, depending on the plan and provider network.

What is a bone density test? 

A bone density test checks how strong your bones are. It can also show if your bones are more likely to break. These tests screen for osteoporosis or osteopenia, which can weaken bones over time.

A bone density test can help:

  • Find bone loss early
  • Diagnose osteoporosis
  • Estimate your risk of fractures
  • Track how well treatment is working
  • Help you and your doctor decide on treatment

Do Humana plans cover bone density tests? 

Yes. All Humana Individual Medicare Advantage plans cover bone density tests at no cost to eligible members when Original Medicare guidelines are followed. To be eligible, you must be at risk of osteoporosis or losing bone mass.

Humana covers 1 bone density test every 24 months. Coverage extends to either a preventive or diagnostic scan. If more than 1 scan is needed in 24 months, a copay will likely be required if the second scan is not deemed medically necessary.

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How to qualify for a bone density test under Medicare

Medicare may cover a bone density test if your doctor or other qualified provider orders it and you meet Medicare rules.

You may qualify if you:

  • Are a woman whose doctor says you have low estrogen and are at risk for osteoporosis
  • Had X-rays that show possible osteoporosis, osteopenia or spinal fractures
  • Take or may start taking steroid drugs for a long time 
  • Have primary hyperparathyroidism
  • Need to see whether osteoporosis medicine is working

Which parts of Medicare cover bone density tests?

Medicare Part A 

Part A (Hospital insurance)  generally covers inpatient hospital care, skilled nursing facility care and some home healthcare . Part A does not usually cover bone density tests unless it’s part of a covered hospital stay.

Medicare Part B

Part B typically covers bone density tests for people who qualify. This is the main Medicare coverage people use for osteoporosis screening and follow-up tests. 

Medicare Advantage (Part C) 

Medicare Advantage plans  cover at least the same services as Original Medicare, including medically necessary bone density tests. Your costs may be different depending on your plan. Some plans may also have network rules or require prior authorization.

What types of bone density tests are covered by Medicare?

Medicare can cover different types of bone density tests, based on your medical needs.

What types of bone density tests are covered by Medicare?

Test type 

Covered by Medicare

Typical use

DEXA/DXA Scan

Yes, when Part A or Part B coverage criteria is met.

DEXA is most common bone density test. It’s often used to diagnose osteoporosis and track bone mass loss, especially in the hip and spine. 

Peripheral Test 

Yes, when Part A or Part B coverage criteria is met. 

Peripheral Test checks smaller areas like the wrist, finger, heel or forearm. They can be used in some cases but are usually not as helpful as DEXA scans. 

QCT (Quantitative Computed Tomography): 

Yes, when Part A or Part B coverage criteria is met. 

QCT uses Computed Tomography (CT) imaging to measure bone density, often in the spine. It’s typically used less often than a DEXA scan. 

How much does Medicare pay for bone density tests?

If you have Original Medicare, qualify for coverage and your doctor accepts Medicare, you pay nothing for a bone density test. If you’re enrolled in a Medicare Advantage plan, your costs can depend on copays, coinsurance, deductibles and network rules.2

How often does Medicare cover a bone density test? 

Part B usually covers 1 bone density test every 24 months for people who qualify.

In some cases, Medicare may cover the test more often if it’s medically necessary. For example, your doctor may order it sooner if:2

  • You’re being treated for osteoporosis
  • Your health condition changes

Does Medicare cover the full cost of a DEXA scan? 

Medicare may cover the full cost of a DEXA scan if:

  • You meet Medicare’s eligibility requirements
  • The test is ordered by your doctor or other qualified provider
  • The provider accepts Medicare assignment

Learn more about Medicare 

For more information on the costs, coverage and types of Medicare plans, check out our library of Medicare articles . To see Medicare plans in your area with their premiums, copays and participating doctors and pharmacies, visit our Humana Medicare plans page .

Frequently asked questions

1. Is osteoporosis screening covered by Medicare?

Yes. Medicare covers certain osteoporosis screenings if they’re medically necessary and ordered by a doctor or other qualified provider.

2. Does Medicare require a prior authorization for a DEXA scan?

Original Medicare typically doesn’t require prior authorization for a covered DEXA scan. Some Medicare Advantage plans may require prior authorization or have network requirements.

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