The part of Medicare that covers your X-ray depends on where the test is done and whether you are an inpatient or outpatient.
Rest assured that in most situations, Medicare will cover any medically necessary X-rays to diagnose or assess an illness or injury.
However, like most things under Medicare, coverage varies depending on where you get the X-ray and why you need it. This will affect what portion of the bill you might end up paying.
While Medicare usually covers X-rays of the bones in your back or spine, they won’t be covered if a chiropractor orders them.
Medicare only covers chiropractic services for manual manipulation of the spine to treat subluxation. It does not cover other tests or services ordered by a chiropractor.
X-rays done for dental care are also not covered by Original Medicare (parts A and B). Medicare Advantage (Part C) may have dental coverage, however, if you select a plan that includes these services.
Part A is hospital insurance.
It’s sometimes unclear whether you’ve been admitted as an inpatient or are simply under observation. Even if you stay the night in a hospital, you might be being observed as an outpatient.
Ask your doctor directly about your inpatient status when staying in the hospital and how this status will affect your Medicare coverage.
Part A covers any tests or services you need during an inpatient stay. However, if you stay in the hospital for observation rather than as an inpatient, Part B coverage may apply instead.
If you receive an X-ray as an inpatient, coverage would fall under Part A.
Here are the basic costs for Part A in 2024:
- $278 to $505 premium, if you have one
- $1,632 deductible for each benefit period
- 20% of all Medicare-approved costs during the stay
- $0 coinsurance for days 1 to 60 of treatment after you pay your deductible
- $408 coinsurance per day for days 61 to 90 of treatment
- $816 coinsurance per day for days 91 to 150 of treatment while using your 60 lifetime reserve days
- 100% of the treatment costs for days 151+
Part B is medical insurance. Part B usually pays for all the diagnostic and medically necessary testing your doctor orders, including X-rays.
Medicare will cover your X-ray at most outpatient centers or as an outpatient service in a hospital. Some of the places you might get an X-ray with your Part B coverage include:
- an outpatient surgery center
- a physician’s office
- the emergency room
- an urgent care center
- an inpatient hospital that offers outpatient radiology services
Here are the basic costs for Part B in 2024:
- $174.70+ monthly premium, if you have one
- $240 deductible
- 20% of all Medicare-approved costs during your treatment
- any copayment or coinsurance fees
If you have Medicare Advantage, also known as Part C, coverage for X-rays would be the same as with Original Medicare (parts A and B).
However, with Part C plans, you may elect to pay for additional coverage that could offset your share of the out-of-pocket costs.
There may also be limits to your coverage with a Part C plan that you wouldn’t have with Part A or B. For example, your coverage might be limited to facilities or healthcare providers within your plan’s network.
Costs vary depending on the Part C plan and provider you choose. Each plan has a different premium, deductible, copayment, and coinsurance amount.
Once you pay your plan’s out-of-pocket maximum, your plan will cover 100% of all Medicare-approved costs.
Medicare supplement insurance, or a Medigap plan, can help cover your share of any costs after getting an X-ray. This may include coinsurance, copayments, and plan deductibles.
Medicare typically covers X-rays, but you’ll likely have to pay some of the cost.
As a general rule, Medicare covers all medically necessary tests and services ordered by a healthcare professional. Exceptions to Medicare coverage for X-rays include those ordered under chiropractic and dental care.
Before going for your X-ray, always check to see if Medicare or your Medicare Advantage plan covers your test, your healthcare professional, and the facility where you’ll have the test done.