Does Medicare Cover PET Scans?

Medicare typically does cover PET scans that are ordered by a doctor. Medicare Part B typically covers diagnostic non-laboratory tests or screenings, like PET scans, to learn how your organs and tissues are functioning.

Medicare Advantage (Part C) plans may also cover PET scans that are deemed medically necessary by your doctor, and they also include an annual out-of-pocket spending limit. This can potentially save you money in out-of-pocket Medicare costs for your PET scans.

Original Medicare does not include an out-of-pocket spending limit.

A doctor smiles as she speaks with a couple

When does Medicare pay for PET scans?

PET scans (positron emission tomography scans) may be ordered by your doctor in order to check for or diagnose a suspected disease or condition.

Some of the conditions a PET scan may be used to diagnose include:

  • Many types of cancer
  • Brain disorders, such as Alzheimer’s disease or tumors
  • Cardiac problems and heart disease

A PET scan may be able to reveal information that aren’t typically seen by a CT scan or an MRI.

Medicare Part B (medical insurance) typically covers your PET scan when ordered by your doctor.

How much does a PET Scan cost with Medicare?

If your PET scan is covered by Medicare Part B, you will typically be responsible for paying a 20 percent coinsurance cost after you meet your Part B deductible.

In 2019, the Medicare Part B deductible is $185 per year.

Speak with your doctor directly for specific cost and coverage information.

Medicare Advantage plans may also cover PET scans

Every Medicare Advantage plan must cover everything that Original Medicare (Part A and Part B) covers.

If your PET Scan is covered by Original Medicare, it will also be covered by a Medicare Advantage plan.

Most Medicare Advantage plans also cover prescription drugs, which are not typically covered by Original Medicare.

You can call to speak with a licensed insurance agent, who can help you compare Medicare Advantage plans that are available in your area.

 

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.