Yes. Medicare Part B pays for annual mammograms, and if your provider accepts Medicare assignment, a screening mammogram costs you nothing out of pocket. Coverage begins with a one-time baseline mammogram for women ages 35 to 39, then one screening mammogram roughly every 12 months for women 40 and older.1Medicare.gov. Mammograms Diagnostic mammograms are also covered whenever a doctor determines they are medically necessary, but those carry cost-sharing.
Who Qualifies and How Often
Federal law sets hard limits on how often Medicare will pay for a screening mammogram.2Office of the Law Revision Counsel. 42 US Code 1395m – Special Payment Rules for Particular Items and Services
- Under 35: no coverage for a screening mammogram.
- Ages 35 to 39: one baseline screening mammogram, once in your lifetime.
- Age 40 and older: one screening mammogram once at least 11 full months have passed since the month of your last one.
That 11-month rule is where people get caught. If your last screening was in March 2026, the earliest Medicare will pay for the next one is March 2027. Schedule it a few weeks early and Medicare can deny the claim, leaving you to pay the full bill.2Office of the Law Revision Counsel. 42 US Code 1395m – Special Payment Rules for Particular Items and Services
Diagnostic mammograms follow different rules. There is no age minimum and no frequency cap. As long as your doctor orders one with a documented medical reason, Medicare covers it.1Medicare.gov. Mammograms
What You Pay
Screening Mammograms
Nothing, as long as your provider accepts Medicare assignment. No deductible, no coinsurance.1Medicare.gov. Mammograms A provider who accepts assignment agrees to take the Medicare-approved amount as full payment.3Medicare.gov. Does Your Provider Accept Medicare as Full Payment? A provider who doesn’t accept assignment can charge you more, so this is worth confirming when you schedule.
Diagnostic Mammograms
Diagnostic mammograms are not free. You pay the annual Part B deductible if you haven’t already met it, then 20% of the Medicare-approved amount. In 2026, the Part B deductible is $283.4Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles So if the approved amount for the exam is $200 and your deductible is already met, you owe $40. If it isn’t, the $200 applies to the deductible first.
A Medigap policy may pick up some or all of that 20%, depending on which plan letter you have.
When a Free Screening Becomes a Billed Exam
This is the scenario behind most surprise bills. You go in for a routine screening mammogram. The radiologist sees something that warrants a closer look and takes additional images during the same visit. At that point the visit is reclassified, and the extra imaging is billed as diagnostic with the standard 20% coinsurance.5Centers for Medicare & Medicaid Services. Article – Billing and Coding: Breast Imaging Mammography
The screening portion itself stays free. You only owe your share on the diagnostic portion. If a bill arrives after what you thought was a no-cost mammogram, this conversion is almost always why.
3D Mammograms
Medicare covers 3D mammography, also called breast tomosynthesis. CMS billing guidelines have facilities report tomosynthesis alongside the standard mammography codes, so it falls under the same screening or diagnostic benefit.6Centers for Medicare & Medicaid Services. Mammograms – Indications and Limitations of Coverage A 3D screening should still cost you nothing when the provider accepts assignment. Some facilities bill the 3D piece separately, though, which can create confusion, so it’s worth asking ahead of the appointment whether the full exam will be billed as a covered screening.
Scheduling Your Mammogram
You don’t need a doctor’s referral or order for a screening mammogram. You can call a certified mammography facility and book it yourself.7Centers for Medicare & Medicaid Services. LCD – Breast Imaging Mammography/Breast Echography A diagnostic mammogram does require a physician’s order, because Medicare needs documentation of medical necessity.
When you call to schedule, confirm two things: the facility holds an FDA-issued mammography certificate (required by federal law for Medicare to pay), and the provider accepts Medicare assignment.2Office of the Law Revision Counsel. 42 US Code 1395m – Special Payment Rules for Particular Items and Services Bring your Medicare card, and the facility bills Medicare directly.
If You Have Medicare Advantage
Medicare Advantage plans (Part C) are required to cover at least what Original Medicare covers, so your annual screening mammogram must be available at no cost under the same age and frequency rules. Some plans add extras, like reduced cost-sharing on diagnostic mammograms. Check your plan’s Evidence of Coverage for specifics.