Does Medicare Cover Calcium Score Tests?


Calcium score tests help detect narrowing of the arteries, which raises your risk of heart disease.

About 47% of people in the U.S. have at least one risk factor for heart disease, such as high blood pressure, high cholesterol, diabetes, obesity, unhealthy diet, physical inactivity, or excessive alcohol use.

In fact, about 18.2 million adults aged 20 and older have coronary artery disease (CAD) and about 805,000 people in the U.S. have a heart attack each year. To detect cardiovascular disease early and lower your risk of heart attack or stroke, it's important to take advantage of Medicare covered preventive and screening services when you're eligible.

Additionally, if you have increased risk for heart disease, you may want to talk to your doctor about a calcium score test. Read on to learn about what a calcium score test is, who should get one, and Medicare's coverage of the test.

What is a calcium score test?

A calcium score test (or coronary calcium scan) is a screening heart test that uses computerized tomography (CT) to detect calcium deposits in the coronary arteries of your heart. If you have a higher calcium score, you have a higher chance of significant narrowing in the coronary arteries and higher risk of heart attack.

Before the scan begins, the technician will attach small, sticky patches called electrodes to your chest. These hook up to a device that records your heart activity during the exam and coordinates the timing of X-ray pictures between heartbeats. You may also be given medication, either a pill or injection, that slows your heart and allows for better images.

During the scan, you'll lie on your back on a table that slides into the CT scanner. You'll be asked to remain very still and hold your breath for a few seconds at a time while the images are taken. The whole procedure should take about 10-15 minutes.

Calcium score test results

Your score will reflect the total area of calcium deposits and the density of the calcium. The higher the score, the higher your risk of heart disease:

  • Score of 0 means no calcium is seen in the heart, and you're at the lowest risk of developing a heart attack in the future
  • Score of 100-300 means moderate plaque deposits, associated with relatively high risk of heart attack or heart disease
  • Score greater than 300 is a sign of high to severe disease and heart attack risk

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While this scan shouldn't be the only screening you rely on to predict your risk of heart disease, talk with your doctor about your scan results to learn about the best treatment plan moving forward. This could include medications, changes to your diet or exercise routine, updating weight loss goals, or having other tests performed.

Who should get a calcium score test?

You should ask your doctor about a calcium score test if you're between the ages of 40-70 and at increased risk for heart disease, but do not have symptoms. Risk factors include:

  • Family history of heart disease
  • Past or present smoker
  • History of high cholesterol, diabetes, or high blood pressure
  • Obesity
  • Inactive lifestyle
  • Other non-traditional risk factors

If you believe you're at increased risk, talk to your doctor about any screening or diagnostic tests (like a calcium score test) that you may be eligible for or need.

How often does Medicare cover a calcium score test?

Medicare Part B covers diagnostic, non-laboratory tests such as CT scans, MRIs, EKGs, X-rays, and PET scans when your provider orders them as part of treating a medical problem.

In the case of a calcium score test, it would likely be covered by Medicare as long as your provider can prove it's medically necessary AND it isn't classified as a screening exam. This means you must be showing symptoms of a heart issue, be at increased risk, or your doctor must have probable cause for ordering the test. You'll also likely need a referral.

If you're eligible for coverage, you'd pay 20% of the Medicare-approved amount and the Part B deductible applies. You'll also pay a co-payment if the test was performed in a hospital outpatient setting.

Medicare Part B also covers a number of other cardiovascular disease screenings such as a cardiovascular screening blood test (checking cholesterol, lipid, and triglyceride levels), an abdominal aortic aneurysm screening, cardiovascular behavioral therapy, cardiac rehabilitation programs, and cardiac catherization. Some heart procedures, such as angioplasties and stents, are also covered.

Use Medicare's Coverage Search tool to learn specifics about if your test, item, or service is covered.

And to learn which Medicare plans are available in your area, use our Find a Plan tool. Just enter your zip code to begin comparing Medicare plan prices and benefits.

Additional resources

Kolt Legette
Since 2003, Kolt Legette has helped clients navigate the often-confusing world of insurance. His number one goal is protecting the medical and financial wellbeing of every person he speaks with, whether they choose to buy insurance or not. Kolt loves representing the best brands in medical insurance as it allows him to provide side-by-side comparisons for his clients. This allows the client to decide which company works best for them. By putting the needs of the client above everything else, Kolt helps real people find affordable health insurance solutions for their most pressing healthcare needs. With his belief that peace of mind is priceless, Kolt's goal in every interaction is to make sure each person he speaks to leaves with the peace of mind they rightfully deserve.


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