Does Medicare Cover an Echocardiogram?

Last Updated : 09/20/20183 min read

Each day the average heart beats 100,000 times and pumps about 2,000 gallons of blood according to the American Heart Association. But this powerful vital organ is susceptible to disease. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in both men and women.

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If your doctor is concerned about your heart health, he may order an echocardiogram.

What is an echocardiogram?

An echocardiogram uses sound waves to create pictures of your heart’s chambers, valves, walls and blood vessels, according to the American Heart Association. This test is different from an electrocardiogram, which records the electrical signals of your heart. An electrocardiogram or EKG may also be used during your echocardiogram to record your heartbeat during the test. During an echocardiogram, a technician passes a probe across your chest which produces sound waves that bounce off your heart and “echo” back to the probe. The soundwaves then are displayed as pictures on a video monitor. An echocardiogram is generally painless and can be done as an outpatient procedure.

Why would I need an echocardiogram?

If you have a shortness of breath or chest pain a doctor may suggest an echocardiogram to diagnose problems with the valves or chambers of the heart, according to the Mayo Clinic. A doctor may use an echocardiogram to find out if there are problems with the outer lining of the heart or problems with the large blood vessels that enter and exit the heart, according to the American Heart Association. An echocardiogram may also detect blood clots in the chambers of the heart and abnormal holes between the chambers of the heart.

Echocardiogram cost

An echocardiogram can cost between $1,000 and $2,000 according to choosingwisely.org. The echocardiogram cost may differ according to your location, the type of facility you go to, how much your doctor charges, and other insurance you may have. Some of the echocardiogram cost may be covered by Medicare.

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Does Medicare cover an echocardiogram?

Medicare Part A covers hospital care and Medicare Part B covers doctor services. Medicare Part B covers diagnostic non-laboratory tests, such as echocardiograms, when your health care provider orders them as part of treating a medical problem. These tests may help your doctor diagnose or rule out a suspected illness. An echocardiogram can also help identify whether an area of your heart has been damaged by a heart attack, according to the Mayo Clinic.  For diagnostic non-laboratory tests you generally pay 20 percent of the Medicare-approved amount. The Part B deductible also applies.

Of course, your costs may be different if you’re enrolled in a Medicare Supplement or Medicare Advantage plan that may pay some or all of your heart scan copayment and deductible. Medicare Advantage plans are an alternative way to receive your Medicare Part A and Part B coverage, and these plans may have lower costs than Original Medicare. Medicare Supplement plans work alongside your Original Medicare coverage and may help pay for certain out-of-pocket costs.

Do you have more questions about Medicare coverage of heart health?

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