Yes, Medicare covers mammograms, but a screening mammogram and a diagnostic mammogram don't cost the same thing. A screening mammogram, the routine yearly check, is free for women 40 and older. A diagnostic mammogram, the kind you get after a lump or an abnormal result, is not. Knowing which one you're getting is the difference between a free visit and a real bill.
In This Guide
- Key Takeaways
- What Medicare Covers for a Mammogram
- Is a Mammogram Free? The Screening and Diagnostic Split
- Does Medicare Cover a 3D Mammogram?
- What Happens After an Abnormal Mammogram
- Frequently Asked Questions
- Learn More
What Medicare Covers for a Mammogram
Medicare Part B covers mammography two different ways, and it helps to think of them as two separate benefits because they're billed differently.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms
The first is the screening mammogram, the routine test you get when you have no symptoms. For a woman 40 or older, Medicare covers one screening mammogram once every 12 months. There's also a one-time baseline screening mammogram for a woman between 35 and 39, covered once in her lifetime.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms
The second is the diagnostic mammogram. That's the one furnished to someone who has signs or symptoms of breast disease, a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease. Because it's looking into a specific problem rather than screening a healthy person, Medicare treats it, and prices it, differently. And unlike the once-a-year screening, a diagnostic mammogram can be done more than once in a year when it's medically necessary.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms
Is a Mammogram Free? The Screening and Diagnostic Split
"Mammograms are free under Medicare" is only half true. Whether you pay comes down to which kind of mammogram you're getting.
The screening mammogram is free. When your provider accepts assignment, you pay $0 for your yearly screening mammogram: no Part B deductible, no coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms The same goes for that once-in-a-lifetime baseline screening if you're between 35 and 39.
The diagnostic mammogram is not free. It isn't treated as a $0 preventive service. After you've met the annual Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for the diagnostic mammogram.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles So if your visit is coded as diagnostic rather than screening, expect a bill for that portion.
The practical takeaway: the word on your order, "screening" or "diagnostic," is what drives the cost. If you're due for your routine yearly check and have no symptoms, that's a screening mammogram and it should cost you nothing. If it's follow-up on a lump, a prior cancer, or an earlier abnormal result, it's diagnostic, and the deductible and coinsurance apply.
Does Medicare Cover a 3D Mammogram?
Medicare covers 3D mammography, also called digital breast tomosynthesis or DBT, for services dated on or after January 1, 2015.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms
A 3D mammogram follows the cost-sharing of the study underneath it. If it's done as part of your routine screening, the 3D portion is $0, just like a standard screening mammogram. If it's done as part of a diagnostic workup, it falls under the diagnostic rules, meaning the Part B deductible and then 20% coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles So 3D doesn't change whether you pay; screening versus diagnostic still does.
What Happens After an Abnormal Mammogram
The free part covers screening, and only screening. If your screening mammogram turns up something that needs a closer look, the follow-up is no longer the free preventive test.
A repeat mammogram ordered to investigate a finding is a diagnostic mammogram, billed the diagnostic way: the Part B deductible if you haven't met it, then 20% of the approved amount.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles Other follow-up, like a breast ultrasound or a biopsy, is billed the standard Part B way too. For most outpatient services, you pay 20% of the Medicare-approved amount after the deductible.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
None of that is a reason to skip your screening. It's just worth knowing that the $0 stops at the first test, and anything ordered to chase down a result is priced as diagnostic care.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms
Frequently Asked Questions
Does Medicare cover a mammogram?
Yes. Medicare Part B covers a yearly screening mammogram for women 40 and older, a one-time baseline screening for women 35 to 39, and diagnostic mammograms when they're medically necessary. The screening version is free; the diagnostic version is billed.
How much does a mammogram cost with Medicare?
A screening mammogram costs $0 when your provider accepts assignment. A diagnostic mammogram costs you the Part B deductible ($283 in 2026) and then 20% of the Medicare-approved amount.Centers for Medicare & Medicaid Services. (n.d.). Mammograms - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/mammograms,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
How often does Medicare cover a mammogram?
One screening mammogram every 12 months for women 40 and older. A diagnostic mammogram can be covered more than once in a year when it's medically necessary.
Does Medicare cover 3D mammograms?
Yes. Medicare covers 3D mammography (digital breast tomosynthesis) for services on or after January 1, 2015. It follows the cost of the underlying study, so a 3D screening is $0 and a 3D diagnostic mammogram falls under the deductible and 20% coinsurance.
Why did I get a bill for my mammogram if screening is free?
The most common reason is that the mammogram was coded as diagnostic rather than screening, which happens when it's follow-up on symptoms, a prior breast cancer, or an earlier abnormal result. Diagnostic mammograms are subject to the Part B deductible and 20% coinsurance, so a bill for that portion is expected.
Learn More
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