Diagnostic non-laboratory tests
Medicare Coverage Information
Overview
Medicare provides coverage for various diagnostic non-laboratory tests that help healthcare providers diagnose and monitor medical conditions. These tests typically include medical imaging and diagnostic procedures that are deemed medically necessary by a healthcare professional.
- Covers diagnostic tests ordered by a qualified healthcare provider
- Must be medically necessary for diagnosis or treatment
- Includes imaging tests like X-rays, CT scans, and MRIs
- Requires prior authorization for some advanced diagnostic procedures
- Coverage may vary between Original Medicare and Medicare Advantage plans
- Medicare Part B beneficiaries
- Individuals with a qualifying medical condition
- Tests must be recommended by a healthcare provider
- Part B typically covers diagnostic non-laboratory tests
- Beneficiaries usually pay 20% of the Medicare-approved amount after meeting the Part B deductible
- Costs may vary depending on the specific test and healthcare setting
- Tests must be ordered by a Medicare-enrolled physician
- Cosmetic or screening tests without medical necessity may not be covered
- Some advanced or experimental diagnostic tests might require additional review
- Consult with your healthcare provider about necessary diagnostic tests
- Verify coverage with your specific Medicare plan
- Obtain a referral from your primary care physician if required
- Contact Medicare at 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare diagnostic testsnon-laboratory testsmedical imagingdiagnostic proceduresMedicare coverage
Related Coverage Topics
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