Clinical laboratory tests
Medicare Coverage Information
Overview
Medicare covers a wide range of clinical laboratory tests that are medically necessary for diagnosing or monitoring health conditions. Most preventive and diagnostic lab tests are fully covered under Medicare Part B with no additional cost to beneficiaries.
- Medicare covers most medically necessary clinical laboratory tests
- No copayment or coinsurance for most lab tests ordered by a qualified healthcare provider
- Tests must be performed by Medicare-certified laboratories
- Includes blood work, urinalysis, screenings, and diagnostic tests
- Frequency of tests depends on medical necessity and individual health conditions
- Applies to Original Medicare (Part B) beneficiaries
- Eligible Medicare Advantage plan participants
- Individuals aged 65 and older
- Younger individuals with qualifying disabilities
- Most clinical laboratory tests are covered at 100% with no out-of-pocket costs
- No deductible applies for standard lab tests
- Additional tests beyond preventive screenings may have associated costs
- Tests must be ordered by a qualified healthcare provider
- Must be medically necessary and not considered experimental
- Performed by Medicare-certified clinical laboratories
- Some specialized or advanced tests may require prior authorization
- Consult with your healthcare provider about necessary laboratory tests
- Confirm the laboratory is Medicare-certified before testing
- Review your specific Medicare plan's coverage details
- Call 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare laboratory testsclinical lab tests coverageMedicare diagnostic screeningsmedical lab work Medicarepreventive laboratory services
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