Does Medicare Cover an Echocardiogram?

Is an echocardiogram covered by Medicare?

An echocardiogram is an ultrasound of your heart. It uses sound waves to create moving pictures of your heart's chambers, valves, walls, and blood flow. A common version, the transthoracic echocardiogram (billing code CPT 93306), combines this imaging with Doppler to measure how blood moves through the heart.

Medicare covers an echocardiogram as a diagnostic test, not as a routine screening. That means it is covered when a doctor or other qualified provider orders it to find out what is wrong or to manage a known heart condition. Diagnostic non-laboratory tests like this fall under Medicare Part B, and Part B pays only when the test is medically necessary.

• Covered: ordered by your provider to diagnose or monitor a heart problem.
• Not covered: a routine echocardiogram for someone with no symptoms or signs of heart disease.
• The test must be ordered by a treating physician and performed by a qualified provider; to avoid surprise costs, confirm your provider accepts Medicare assignment before the test.

Which part of Medicare pays - Part A or Part B?

It depends on where and how you get the test. Most echocardiograms are done in an outpatient setting, so they are billed under Part B (medical insurance).

If the echocardiogram is done during a Medicare-covered inpatient hospital stay, it is part of your inpatient care and is covered under Part A (hospital insurance) rather than billed separately under Part B. For 2026, the Part A inpatient hospital deductible is $1,736 per benefit period, which covers your inpatient stay overall rather than just the test.

• Doctor's office or independent testing facility: billed under Part B.
• Hospital outpatient department: billed under Part B, but with an added hospital copay.
• Admitted as an inpatient: part of your Part A inpatient stay.

How much does an echocardiogram cost with Medicare in 2026?

For a diagnostic echocardiogram billed under Part B, you first meet your annual Part B deductible, which is $283 in 2026. After that, you generally pay 20% of the Medicare-approved amount, and Medicare pays the other 80%. The standard Part B monthly premium in 2026 is $202.90.

Where you have the test affects your bill. If you go to a hospital outpatient department, you may also owe a separate hospital copayment that can be more than 20% of the approved amount; in most cases that hospital copay for a single service cannot be more than the Part A hospital deductible amount. A doctor's office or independent diagnostic testing facility usually does not add that extra hospital copay.

Costs vary by region and provider. To compare what you might pay at a hospital outpatient department versus an ambulatory surgical center, you can use Medicare's Procedure Price Lookup tool and search the echocardiogram code (93306).

• 2026 Part B deductible: $283 per year.
• Your share after the deductible: 20% coinsurance (office or testing facility).
• Hospital outpatient: 20% plus a possible hospital copay, generally capped per service at the Part A deductible amount.
• Done as an inpatient: covered under the 2026 Part A deductible of $1,736 per benefit period.

When is an echocardiogram medically necessary?

Medicare's regional rules (called Local Coverage Determinations) describe when a transthoracic echocardiogram is considered medically necessary. Coverage applies when there is a documented heart-related reason for the test, and the test must be ordered by a treating physician.

Routine screening of people who have no symptoms and no signs of heart disease is generally not covered. Keep in mind that a cardiovascular echocardiogram is different from the cardiovascular disease blood-test screenings (cholesterol, lipids, and triglycerides) that Part B covers once every 5 years at no cost when the provider accepts assignment. Those are separate blood tests, not an echocardiogram, and they don't replace one.

• Evaluating a heart murmur.
• Valvular (heart valve) disease.
• Suspected congenital heart disease.
• Complications after a heart attack (myocardial infarction).
• Cardiomyopathy (disease of the heart muscle).

Medicare Advantage and Medigap coverage

Medicare Advantage (Part C) plans must cover at least the same echocardiogram benefits as Original Medicare. However, an Advantage plan may require prior authorization for a non-emergency outpatient echocardiogram and may require you to use in-network providers. Your copay is set by the plan and can differ from Original Medicare's 20% coinsurance, so check your plan's Evidence of Coverage and ask whether prior authorization or a referral is needed before you schedule the test.

If you have Original Medicare and a Medigap (Medicare Supplement) policy, the Medigap plan can help pay your 20% Part B coinsurance for the echocardiogram. Most Medigap plans cover the Part B coinsurance; the exact help depends on which Medigap plan you have, so confirm with your plan.

Types, repeat tests, and appeals

Medicare can cover different types of echocardiograms when they are medically necessary and ordered for a documented reason, including transthoracic (the standard chest ultrasound), transesophageal, stress echo, and Doppler studies. The right type depends on your provider's clinical judgment.

There is no single fixed schedule for how often Medicare will pay for a repeat or follow-up echocardiogram. Coverage of a follow-up test depends on whether it remains medically necessary based on your condition and your provider's documentation.

If Medicare denies coverage for your echocardiogram, you have the right to appeal. Your Medicare Summary Notice (for Original Medicare) or your plan's denial notice (for Medicare Advantage) explains the reason for the denial and how to file an appeal, including the deadlines you must meet.