Short answer: Medicare Part B covers screening colonoscopies. The covered frequency depends on colorectal cancer risk and prior screening. A colonoscopy performed to evaluate symptoms is diagnostic and follows ordinary Part B cost-sharing rules.
Original Medicare coverage
A screening colonoscopy looks for precancerous polyps, cancer, and other disease in the colon and rectum. Medicare does not impose a minimum age for a screening colonoscopy. Part B also covers a follow-up colonoscopy as a screening test after a positive Medicare-covered non-invasive stool test or blood-based biomarker screening test.
Eligibility and limits
Medicare lists screening intervals of 24, 48, or 120 months depending on the patient’s risk and the type and timing of previous colorectal screening. A provider should determine the appropriate interval. A colonoscopy for bleeding, pain, anemia, a known condition, or another symptom is not the same as an average-risk preventive screening.
The endoscopist and facility must be eligible to bill Medicare. Anesthesia, pathology, treatment, and facility services may be billed separately under applicable rules.
Costs
You pay nothing for a covered screening colonoscopy when the provider accepts assignment. This includes a qualifying follow-up colonoscopy after a positive covered non-invasive screening test. If tissue is removed or another service is provided, cost sharing may apply to some treatment services. Diagnostic colonoscopies generally have Part B deductible and coinsurance rules.
Medicare Advantage
Medicare Advantage plans cover Medicare-covered colorectal screening. Network, referral, and authorization rules may apply. Ask the plan how it treats a screening procedure that results in polyp removal or other treatment.
What to do next
- Ask whether the procedure is screening or diagnostic.
- Confirm the date and type of your prior colorectal screening.
- Verify the endoscopist, facility, anesthesia provider, and pathology laboratory.
- Ask how costs may change if a polyp is removed.
Coverage is determined from the claim, the patient’s eligibility, provider status, and applicable Medicare rules. A provider’s recommendation does not guarantee payment. Before a planned service, ask the provider what will be billed and ask Medicare or the plan whether any coverage review is required.
Sources
Last reviewed: August 2026. Medicare rules and plan benefits can change.