Does Medicare Pay for an Echocardiogram?
The answer is yes; Original Medicare covers echocardiograms when deemed medically necessary.
Medically necessary means a doctor has determined that the test is needed to diagnose or treat a specific medical condition. If you have Original Medicare Part A and Part B, your coverage will depend on where you receive the test and how it is administered.
How Much Does an Echocardiogram Cost?
Medicare Part B covers echocardiograms in a doctor’s office or outpatient facility. Before Part B coverage, the price for an echocardiogram can range from $1,000 to $3,000 on average. You are responsible for paying 20% of the Medicare-approved amount for the test, while Part B covers the remaining 80%. Luckily, a Medicare Supplement plan (Medigap) may cover some or all of your out-of-pocket costs for the echocardiogram.
If you receive your echocardiogram as an inpatient (for example, if you are admitted to the hospital or have a procedure requiring an echocardiogram), it will be covered under Medicare Part A. However, you will be responsible for paying any deductible or coinsurance amounts that apply to your hospital stay.
How Often Can I Receive an Echocardiogram?
There are some restrictions on how often you can receive the test. Generally, Medicare will cover an echocardiogram once every 12 months or more frequently if your healthcare provider deems it medically necessary.
What Is an Echocardiogram?
An echocardiogram is a diagnostic test that utilizes sound waves to generate a visual representation of the heart. It identifies and evaluates various heart conditions, including heart valve disease, heart failure, and irregular heart rhythms. An echocardiogram is a non-invasive procedure, meaning it does not involve any surgical intervention or incision.
Bottom Line
Medicare covers echocardiograms when deemed medically necessary, but knowing how your coverage works and what costs you may be responsible for is important. The information should give you a better understanding of Medicare coverage for echocardiograms so that you can make informed decisions about your healthcare.
Sources: Medicare.gov – Medical News Today – Help Advisor
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