Doctors use an array of tests, scans, and exams to diagnose a wide range of conditions. One of the most useful tools used to diagnose specific medical issues is the CT scan, or computerized tomography. It’s a reality of aging that, for most people, more and more things start going wrong. If your doctor orders a CT scan, you may be concerned about the costs. If you are eligible for Medicare, you may have help paying for your scan.

What is a CT Scan?
You can think of a CT scan as a kind of high-end X-ray process that takes a number of individual X-rays from different angles around your body. Those images are then processed to make a cross-sectional image. These cross-sectional images provide a greater depth of detail and information about everything from bones and muscles to blood vessels.

Common Uses for CT Scans
One of the most common uses for a CT scan is to look for internal injuries you might have sustained from a fall or accident. The scans can prove extremely useful in visualizing fractures. Other common uses for CT scans include:

  • Locating tumors, nodules, or clots
  • Spotting areas of infection
  • Monitor benign tumors or masses for changes
  • Guide other procedures, such as surgery or radiation therapy

CT scans can also help doctors track the effectiveness of a given treatment, such as how chemotherapy or radiation affects tumors.

Medicare Coverage for CT Scans
The coverage you get from Medicare depends on whether you have Medicare Part B. Medicare Part B (Medical Insurance) typically offers coverage for medically necessary diagnostic non-laboratory tests that are ordered by your Medicare-approved physician.  As a general rule, CT scans fall into that category of test. If you only have Part A, Medicare generally will not cover CT scans. If you are enrolled in a Medicare Advantage plan, you will have at least the same Part A and Part B coverage as Original Medicare, but many MA plans include additional coverage.

The rule of thumb is that diagnostic non-lab tests performed on an outpatient basis in a doctor’s office or a non-hospital testing facility get 80% coverage from Medicare Part B, up to the Medicare-approved amount. You pay the other 20%. Your doctor and outpatient testing facility must accept assignment, or agree to the Medicare-approved price, for the scan. If you visit a doctor or facility that is not participating in Medicare, you may be they don’t, responsible for all the costs. Scans that take place in an outpatient department of a hospital typically receive the same coverage from Medicare Part B, but you may also be responsible for a copayment at the time of the procedure.

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