Does Medicare Cover Mammograms? Costs, Frequency, and Rules

Does Medicare cover mammograms, and under which part?

Mammograms are covered under Medicare Part B (medical insurance), which pays for outpatient and preventive services. Part A (hospital insurance) is not the part that pays for routine mammograms, so this is a Part B benefit.

Medicare treats mammograms in two ways depending on why you are getting one. A screening mammogram is a routine check when you have no signs of a problem. A diagnostic mammogram is used when you or your doctor notice something — such as a lump or an abnormal screening result — and need a closer look. The coverage rules and your costs are different for each, which is explained below.

To keep this and all other Part B benefits, you must continue paying your Part B monthly premium, which is $202.90 in 2026 (the standard amount; some people pay more).

How often and at what age does Medicare cover a mammogram?

You do not need to wait a full calendar year between screening mammograms — the rule is once every 12 months. So if your last screening was in March, you become eligible again the following March.

Medicare does not require a referral for a screening mammogram. For a diagnostic mammogram, your doctor orders it because there is a medical reason to investigate further.

• Age 40 and older: Medicare covers one screening mammogram every 12 months.
• Ages 35 to 39: Medicare covers one baseline mammogram — a single mammogram over your lifetime in this age range.
• Diagnostic mammograms: covered more often than once a year when your doctor decides they are medically necessary.

How much does a mammogram cost with Medicare in 2026?

Your cost depends entirely on whether the mammogram is a screening or a diagnostic exam.

Screening and baseline mammograms: You pay nothing — no coinsurance and no Part B deductible — as long as the provider accepts Medicare assignment. "Accepting assignment" means the provider agrees to the Medicare-approved amount as full payment. If your provider does not accept assignment, you could owe more, so it is worth asking before your appointment.

Diagnostic mammograms: You pay 20% of the Medicare-approved amount, and the Part B deductible applies. The 2026 Part B deductible is $283 per year. Once you have met that deductible for the year, you pay the 20% coinsurance on the Medicare-approved amount.

• Screening or baseline mammogram (provider accepts assignment): $0
• Diagnostic mammogram: 20% coinsurance after the $283 (2026) Part B deductible

Does Medicare cover 3D mammograms and other breast imaging?

Medicare covers 3D mammograms — also called digital breast tomosynthesis — under the same rules and costs as standard 2D mammograms. That means $0 for a 3D screening mammogram (when the provider accepts assignment) and 20% after the deductible for a 3D diagnostic mammogram.

Coverage of breast MRI or breast ultrasound is handled separately from the screening mammogram benefit. These are typically ordered as diagnostic tests when medically necessary, and standard Part B cost-sharing (20% after the deductible) would generally apply. Because coverage depends on the medical reason and your specific situation, ask your doctor and confirm with Medicare before the test.

Why was I charged for a mammogram that was supposed to be free?

This is one of the most common surprises. The most frequent reason is that the visit became a diagnostic mammogram rather than a screening one. If you go in for a routine screening but the radiologist finds something that needs immediate follow-up imaging, part of that visit can be billed as diagnostic — which carries the 20% coinsurance and the deductible.

Other reasons include the provider not accepting Medicare assignment, or being outside your plan's network if you have a Medicare Advantage plan. If you are billed and you believe the mammogram should have been a free screening, ask the billing office how it was coded, and review your Medicare Summary Notice or your plan's explanation of benefits.

• Screening turned into a diagnostic exam during the same visit.
• Provider did not accept Medicare assignment.
• Out-of-network provider under a Medicare Advantage plan.
• The 12-month screening clock had not yet reset since your last screening.

Medicare Advantage plans, men, and transgender beneficiaries

Medicare Advantage (Part C) plans must cover mammograms at least as well as Original Medicare. In practice, that means an in-network annual screening mammogram is $0 under a Medicare Advantage plan. However, network rules, provider choices, and the handling of diagnostic mammograms can vary by plan, so check your plan's Evidence of Coverage and use in-network providers to keep your costs lowest.

Coverage is based on medical need, not solely on the sex listed on your record. If a mammogram is medically necessary — which can be the case for men with breast symptoms and for transgender beneficiaries depending on individual medical circumstances — Medicare can cover it. Talk with your doctor about your situation and, if needed, confirm coverage with Medicare or your plan in advance.