Medicare and PSA Tests: Prostate Cancer Screening Coverage
Yes. Medicare Part B covers two prostate cancer screening tests for men over 50: a prostate specific antigen (PSA) blood test and a digital rectal exam (DRE), each once every 12 months starting the day after your 50th birthday. You pay $0 for the yearly PSA blood test when your provider accepts Medicare assignment. For the digital rectal exam, after you meet the Part B deductible ($283 in 2026) you pay 20% of the Medicare-approved amount, plus a hospital copayment if the exam is done in a hospital outpatient setting.
What prostate screening does Medicare cover?
Medicare Part B covers two prostate cancer screening tests: a prostate specific antigen (PSA) blood test and a digital rectal exam (DRE). These are preventive screening tests, meaning they are done to look for prostate cancer before you have any symptoms.
This benefit is set by a national Medicare rule (CMS National Coverage Determination 210.1), which establishes PSA and DRE screening as a covered benefit for men age 50 and over. Because it is a national rule, the basic coverage is the same no matter where you live.
- PSA blood test - a lab test that measures a protein in your blood.
- Digital rectal exam (DRE) - a physical exam performed by your doctor.
Who is eligible and how often?
Medicare covers prostate cancer screening for men over 50. Coverage starts the day after your 50th birthday.
Medicare will pay for each screening test once every 12 months. That means you can get one PSA blood test and one digital rectal exam per year. If you get a screening test more often than once every 12 months, Medicare may not pay for the extra test, and you could be responsible for the full cost.
- Eligibility: men over 50 (begins the day after your 50th birthday).
- Frequency: once every 12 months for the PSA blood test, and once every 12 months for the digital rectal exam.
What do these tests cost in 2026?
The two tests are treated differently for cost.
PSA blood test: You pay $0 for the yearly PSA blood test when your provider accepts Medicare assignment. There is no deductible and no coinsurance for this screening test.
Digital rectal exam (DRE): After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the exam and for your doctor's services. If the exam is done in a hospital outpatient setting, you also pay a hospital copayment. The Part B deductible is $283 for 2026, and the Part B coinsurance rate is 20% of the Medicare-approved amount.
To have Part B coverage at all (which is what pays for these screenings), you must keep paying your Part B premium. The standard Part B monthly premium for 2026 is $202.90, though some higher-income beneficiaries pay more.
- PSA blood test: $0 (no deductible, no coinsurance) when the provider accepts assignment.
- Digital rectal exam: 20% coinsurance after the $283 (2026) Part B deductible, plus a hospital copayment if done in a hospital outpatient setting.
- Standard Part B premium (2026): $202.90 per month.
Why might I still be charged for a "free" PSA test?
Even though the screening PSA blood test should cost you $0, there are a few common reasons you might see a charge.
Provider does not accept assignment. If you get the PSA test from a provider who does not accept Medicare assignment, you may owe an additional fee for the doctor's services - but not for the test itself. "Accepting assignment" means the provider agrees to be paid the Medicare-approved amount as full payment. Asking whether your provider accepts assignment before your visit can help you avoid surprise charges.
It was a diagnostic test, not a screening. The $0 price and the once-every-12-months rule apply to screening - testing done when you have no symptoms. If your doctor orders a PSA test because you have symptoms, a known prostate problem, or to monitor a diagnosis, it is generally treated as a diagnostic test rather than a preventive screening. Diagnostic tests are covered under different Part B cost-sharing rules, which usually means the Part B deductible and 20% coinsurance can apply. Medicare covers medically necessary diagnostic testing, but it is not automatically $0 like the yearly screening.
If you receive a bill you do not understand, check your Medicare Summary Notice or call 1-800-MEDICARE (1-800-633-4227) to ask how the test was billed.
Medicare Advantage and follow-up tests
Medicare Advantage (Part C) plans are required to cover everything Original Medicare covers, so they cover prostate cancer screening too. Many Medicare Advantage plans also charge $0 for the screening PSA blood test, but your other costs, in-network rules, and any referral requirements vary by plan. Check your plan's Evidence of Coverage or call your plan to confirm how it handles these tests and which providers are in network.
Follow-up tests are separate from screening. If your PSA result is high, your doctor may recommend further testing, such as a prostate MRI or a prostate biopsy, to find out what is going on. These are diagnostic tests, not preventive screenings, so they are not covered at $0. Under Original Medicare they are generally covered when medically necessary, with the usual Part B (or Part A, if you are admitted) cost-sharing applying. Under a Medicare Advantage plan, your share of the cost and any prior-authorization rules depend on the plan. Ask your doctor's office for an estimate before any follow-up procedure.
- Medicare Advantage must cover prostate screening; costs and network rules vary by plan - confirm in your Evidence of Coverage.
- Follow-up MRI or biopsy is diagnostic, not screening, so $0 pricing does not apply.
- Diagnostic follow-up is generally covered when medically necessary, with normal Part B (or Part A) cost-sharing.
Frequently asked questions
Does Medicare cover PSA tests and prostate cancer screening?
Yes. Medicare Part B covers two prostate cancer screening tests - a PSA blood test and a digital rectal exam - for men over 50, once every 12 months for each test, starting the day after your 50th birthday.
How much does a PSA test cost with Medicare?
You pay $0 for the yearly screening PSA blood test when your provider accepts Medicare assignment - there is no deductible or coinsurance. If your provider does not accept assignment, you may owe an extra fee for the doctor's services, but not for the test itself.
Does the Part B deductible apply to the digital rectal exam?
Yes. For the digital rectal exam you pay 20% of the Medicare-approved amount after you meet the Part B deductible, which is $283 in 2026. In a hospital outpatient setting you also pay a hospital copayment. The deductible does not apply to the $0 screening PSA blood test.
Why am I being charged when the PSA test is supposed to be free?
The two most common reasons are that your provider did not accept Medicare assignment (so you owe an extra fee for the doctor's service), or the test was ordered as a diagnostic test because of symptoms or a diagnosis rather than as a routine yearly screening. Diagnostic tests follow normal Part B cost-sharing, so they are not automatically $0.
What happens if I get a PSA test more than once in 12 months?
Medicare covers the screening PSA blood test and digital rectal exam once every 12 months each. If you get a screening test more often than that, Medicare may not pay for the extra test, and you could be responsible for the full cost.
Does Medicare cover a prostate biopsy or MRI if my PSA is high?
Follow-up tests like a prostate MRI or biopsy are diagnostic, not preventive screening, so they are not covered at $0. Under Original Medicare they are generally covered when medically necessary, with normal Part B (or Part A) cost-sharing. Under Medicare Advantage, your cost and any prior-authorization rules depend on your plan.
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Medicare Login Guide is an independent resource and is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency. This article is for general information only — confirm current figures and your specific options at medicare.gov or by calling 1-800-MEDICARE.