Does Medicare Cover PET Scans? 

A PET scan, which stands for positron emission tomography, is a type of scan that creates images of internal organs and tissues of living patients. PET scans are used to check for signs of breast, lung, or thyroid cancer; coronary heart disease, heart attack, or other heart issues; brain tumors, epilepsy, dementia, Alzheimer’s, or other brain issues. They also help physicians diagnose whether cancer has metastasized or if current cancer treatments are effective. 

When your doctor performs a PET scan, an IV line is placed into your hand or arm to inject a small amount of a harmless radioactive substance called a radiotracer. The radiotracers are absorbed in high amounts by diseased cells in the body, and they light up in contrast with healthy cells on PET scan images.  

If your health care provider orders a PET scan, your procedure may be covered by Medicare, so here’s a look at how you can qualify for these benefits. 

Does Medicare cover PET scans? 

Medicare recipients who are enrolled in Part B (medical insurance) or a Medicare Advantage (Part C) plan have coverage for diagnostic non-laboratory tests like PET scans, MRIs, EKGs, CT scans, and X-rays if their health care provider orders them to diagnose or treat a medical issue. 

Original Medicare Part B pays 80 percent of the final approved cost of diagnostic non-laboratory tests like PET scans that you have done in a physician’s office or other diagnostic facility if the physician and facility accept Medicare assignment. You pay the rest of this amount (20 percent) after covering your annual Part B deductible amount. 

Through Medicare Part B, you may also be responsible for paying a copayment if you have the testing done in a Medicare-affiliated hospital as an outpatient. In this case, you may be charged more than 20 percent of the final approved amount, but it shouldn’t be more than the Medicare Part A hospital deductible. 

If you undergo a PET scan while you’re an inpatient in a hospital that accepts Medicare, your test is covered by Medicare Part A (hospital insurance) after you meet your Part A deductible for the current benefit period. 

If you have a Medicare Advantage plan, your provider may require that you use medical facilities, laboratories, and physicians that are within your plan’s network of preferred providers. Depending on the type of Part C coverage you have, you may have to pay 100 percent of the cost if you go outside the plan’s network, so check with your provider before having your PET scan if you aren’t sure.

How much does a PET scan cost without Medicare insurance? 

If you don’t have Medicare insurance, the cost of your PET scan will vary according to where you have it done and which part of the body is being scanned. In 2024, the national average cost of a whole-body PET scan is $4,420. However, they can cost between $3,300 and $12,000. Brain scans typically cost between $2,250 and $10,700 and heart scans between $2,850 and $24,200.