How Much Does a PET Scan Cost Through Medicare?
- Is your doctor recommending that you have a PET scan? Read our helpful guide to learn how this imaging test works and the cost of a PET scan through Medicare.
Health care providers rely on a variety of imaging tests to see what's occurring inside our bodies. A positron emission tomography scan, also called a PET scan, is useful for detecting changes in organs and tissues that may indicate disease.
If your doctor is recommending this diagnostic test, you may be wondering how it works and the cost of a PET scan through Medicare.
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Talk to a licensed agent today to find a plan that fits your needs.
What's a PET Scan?
A PET scan is a noninvasive imaging test that uses a radioactive substance to find illnesses in the body. In 2017, there were six PET scans performed for every 1,000 Americans in the United States, or approximately 2.2 million exams.
Imaging tests such as MRI and CT scans detect illness by revealing structural changes in organs and tissues.
By comparison, a PET scan sends a radioactive substance into the bloodstream to detect biochemical changes. These indicate disease even before physical changes can be seen in the body.
How Much Does a PET Scan Cost Through Medicare?
Does Medicare cover PET scans and how much is it? PET scans are covered by Medicare Part B as long as a physician requires the test to diagnose or treat a medical problem. PET scans fall under the category of a diagnostic non-laboratory test.
The out-of-pocket cost of a PET scan through Medicare depends on whether you've met your Part B deductible for the year. Medicare pays 80% of the Medicare-approved amount after the deductible ($240 in 2024) is applied. You're responsible for paying the remainder.
How Much Does a PET Scan Cost Without Medicare?
Nuclear imaging tests, such as PET/CT scans, have a significant price tag.
These costs are subject to a multitude of influences, encompassing:
- Focal Point of Examination: Whether the scan targets the heart, brain, or entails a comprehensive full-body assessment.
- Location Price of Scan: Prices vary across states, cities, and counties, contributing to regional fluctuations.
- Insurance Inclusions: The extent of coverage provided by the patient's insurance plan.
- Medical Facility Type: The choice between outpatient and inpatient hospital settings profoundly impacts pricing dynamics.
How a PET Scan Works
During a PET scan, a small amount of a radioactive compound is injected into your body with a needle. This is usually done intravenously on your forearm, inside elbow or back of the hand. Some radiotracers are taken orally like medicine or administered as a gas that you breathe in.
The radioactive substance then travels to your organs and tissues through your blood. During the exam, a scanner moves over your body, picking up positron signals given off by the tracer and creating computer-generated 3D images. The images show how much cell activity is occurring in the body and where. Cancer cells, for example, show as a bright patch on a PET scan. Damaged tissue with little cell activity shows as a darker area.
The PET exam is often done with a CT scan to determine the functioning, structure and biochemical makeup of organs and tissues. PET scans can identify or rule out medical conditions by analyzing blood flow, metabolism and oxygen use.
What Conditions Are PET Scans Used For?
PET scans help doctors determine whether there's disease in body organs and tissues. This diagnostic test is often used to look for:
- Cancer
- Epilepsy
- Stroke
- Heart disease
- Cardiovascular damage
- Brain or lung tumors
- Head injuries
- Neurological disorders such as Alzheimer’s, Parkinson’s and Huntington’s disease
- Improvements during cancer treatment
What to Expect During a PET Scan
Most PET scans are performed on an outpatient basis. Here's what you can expect during a typical PET scan, although specific procedures may depend on a health care facility's policy and your medical condition.
- Prior to the scan, you may be asked to fast.
- You must wear a gown and remove jewelry to prevent obstructions during the scan.
- A radioactive compound is injected into your arm or hand through an intravenous line. In some cases, the radiotracer is swallowed or inhaled.
- You must wait up to an hour for your body to absorb the radiotracer.
- When the scan begins, you lay down on a narrow, padded table. The table slides inside a tunnel-shaped scanner that moves slowly over your body and produces images.
- You must remain still during the scan, which can take up to 40 minutes. Speak with your health care provider if you have claustrophobia or are anxious about enclosed spaces.
PET scans are painless, and you should be able to leave once the test is complete without requiring recovery time.
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Are PET Scans Safe?
The amount of radiotracer used in a PET scan is very small. The radiation exposure is less than a typical X-ray, and there's little risk of negative effects from a single scan.
Drink a generous amount of fluids after the scan to help clear the radioactive compound from your system. It should take less than 10 hours to be eliminated from your body.
As with any test, discuss your medications, allergies and sensitivities with your health care provider prior to a PET scan.
For more information about how much does a PET scan cost with Medicare, call 1-800-MEDICARE (1-800-633-4227) if you have Original Medicare. Call your private insurance company if you have a Medicare Advantage plan.
