Medicare Part B covers qualifying mammograms. What you pay depends on whether the exam is a covered screening or a medically necessary diagnostic test. The word “mammogram” alone does not establish that every related service is free.
Screening and diagnostic exams have different rules
| Exam | Who and how often | Original Medicare cost |
|---|---|---|
| Baseline mammogram | One baseline exam for women ages 35–39. | No test charge when the provider accepts assignment. |
| Screening mammogram | Women age 40 or older, once every 12 months. | No test charge when the provider accepts assignment. |
| Diagnostic mammogram | When medically necessary; it can be more frequent than annual screening. | Generally 20% of the approved amount after the Part B deductible. |
Does Medicare cover 3D mammograms?
Medicare recognizes digital breast tomosynthesis, often called 3D mammography. CMS billing rules pair it with the corresponding screening or diagnostic mammogram. It is not an unrestricted extra screening benefit: the age and frequency requirements still apply when it accompanies a screening exam.
Before the appointment, ask whether the scheduled study is screening or diagnostic, whether 3D imaging is included and whether the facility accepts Medicare assignment. A follow-up diagnostic study is not automatically cost-free because the first screening was covered without cost sharing.
What about ultrasound or other follow-up imaging?
Part B covers medically necessary breast ultrasound when ordered by your health care provider. A recommendation does not automatically make an additional exam part of the no-cost screening benefit. Ask for the exact service and an estimate of your responsibility.
In 2026 the Part B annual deductible is $283. Whether you have met it, other insurance and the place of service can affect a diagnostic bill. Medicare Advantage must cover applicable Medicare services, but its network, referral and cost rules may differ. Review your plan before scheduling non-emergency care.
A short appointment checklist
- Give the office the date and type of your last mammogram.
- Confirm the reason for the new exam with the ordering clinician.
- Ask about assignment, network participation and any required authorization.
- Request a written estimate for diagnostic or additional services.
- Compare the claim notice with the services actually provided.
There is no upper age cutoff stated in Medicare’s screening benefit for eligible women age 40 or older. Decisions about which tests are appropriate belong with your clinician; this guide explains insurance coverage rather than recommending a test.
Related coverage questions
- Medicare Part B: Medical Coverage, Costs and Enrollment
- Medicare Coverage Database: How to Read NCDs and LCDs
- How to Find and Verify a Medicare Provider