An electroencephalogram, or EEG, is a non-invasive test that detects and records the brain’s electric activity. Health care providers use EEGs to find brain wave abnormalities caused by trauma, are causing negative health conditions such as seizures. There are three main types of EEGs:
Standard EEG testing takes place in the office of your physician, in a clinic, or in a hospital on an outpatient basis. You stay awake during a standard EEG, it takes no longer than an hour, and there is no preparation necessary beforehand. A technician applies small metal discs that are connected to wires to your scalp. These send the signals from the brain to a computer where the results are recorded.
A sleep or sleep-deprived EEG is generally used to detect sleeping disorders, or if more information is needed after a standard EEG has been done. This type of EEG takes place while you are sleeping. Your health care provider may ask you to stay awake the night previous to your test for more accuracy during the exam.
An ambulatory EEG is a 24-hour EEG that monitors and records brain activity during your daily routine and while you are sleeping. Electrodes are attached to a portable recorder that you can easily clip on to your clothing. The device is not waterproof, so you should not get it wet.
Your physician may feel it is advisable for you to have one of the above types of EEGs done if you are experiencing changes in your behavior, problems due to a sleeping disorder, seizure disorders, or have had a recent head injury. If this is the case, you may need information about how your Medicare benefits cover the expense of an EEG test. This article gives you information about your Medicare coverage for EEGs.
Why is your health care provider suggesting you have an EEG? Your physician may order an EEG if he or she suspects that your condition or symptoms are the result of abnormal brain activity. Some of the instances include the following examples:
• You are experiencing abnormal dizziness or headaches.
• After a stroke, head injury, or infection.
• To discover or rule out a brain tumor.
• To investigate a sleeping disorder.
• If you have a seizure disorder, the EEG may show the region of your brain that
is affected by abnormal brain activity.
• To diagnose and treat epilepsy.
• To diagnose Alzheimer’s or other forms of dementia.
Do Your Medicare Benefits Cover EEGs?
EEGs are diagnostic tools that physicians use to discover and treat certain conditions caused by brain wave abnormalities.
If you have Original Medicare Part B (medical insurance), or a Medicare Advantage (Part C) plan, you have coverage for EEGs. Medicare categorizes EEGs of all types as diagnostic lab tests and pays for 100 percent of their cost.
To be eligible for this coverage, your health care provider must order it and certify that it is medically necessary. Both your physician and the lab or clinic that conducts the EEG must accept Medicare assignment. An ambulatory EEG is covered under Medicare if your physician suspects that you are having seizures, but this has not been proven by a previous standard or sleeping EEG.
If you do not have Medicare benefits or another form of health insurance, you may end up paying for an EEG exam. Although prices vary from state to state, the average cost for a standard EEG is between $200.00 and $700.00. An ambulatory EEG costs between $760.00 and $1260.00. These prices are for the EEG alone, not for the physician’s fee. A neurologist or physician specializing in the brain and nervous system interprets the information gathered by the EEG and gives a diagnosis.
If you have any questions about your coverage for diagnostic laboratory tests like EEGS either through Original Medicare Part B, or your Medicare Advantage policy, you can get answers from a licensed representative at your plan.
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