Short answer: Medicare Part B covers medically necessary services from a dermatologist. Medicare does not generally cover cosmetic care or removal of a benign skin lesion only to improve appearance.
Original Medicare coverage
Part B covers medically necessary doctor services used to diagnose or treat illness or injury. This can include evaluation and treatment of a suspicious lesion, skin cancer, infection, inflammatory disease, or another documented medical problem. Coverage of a specific procedure depends on medical necessity and applicable national or local Medicare policy.
CMS local coverage policies state that removal of a malignant lesion is medically necessary. Removal of a benign lesion may be covered when documentation shows symptoms or a threat to health or function, such as bleeding, pain, inflammation, obstruction, or clinical uncertainty about the diagnosis. Removing an asymptomatic benign lesion for appearance is cosmetic and is not covered.
Eligibility and limits
The record must support the reason for the visit and any procedure. Medicare does not provide a general preventive skin-cancer screening benefit for every person without symptoms or risk findings. A medically necessary examination prompted by a concerning change or a provider’s clinical assessment may be covered under the doctor-services benefit.
Costs
After the Part B deductible, you generally pay 20 percent of the Medicare-approved amount for covered dermatologist services. Laboratory or pathology services and facility charges may be billed separately. You pay the full cost of noncovered cosmetic services.
Medicare Advantage
Medicare Advantage plans cover medically necessary dermatology services covered by Original Medicare. The plan may require an in-network dermatologist, referral, or prior authorization for a procedure. Optional cosmetic care is not made covered merely because the patient has Medicare Advantage.
What to do next
- Ask the provider to identify the medical reason for the visit or procedure.
- Confirm Medicare enrollment or plan network status.
- Ask whether pathology or facility charges will be separate.
- Request a coverage notice and price for cosmetic or possibly noncovered care.
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
- Medicare.gov: Doctor and health care provider services
- CMS: Removal of benign and malignant skin lesions LCD
- Medicare.gov: Cosmetic surgery
Last reviewed: August 2026. Medicare rules and plan benefits can change.