Short answer: Medicare Part B covers medically necessary MRI scans when a doctor or other qualified provider orders the test to diagnose or treat a medical condition. Coverage does not apply merely because a patient requests a scan.
Original Medicare coverage
An MRI is a diagnostic non-laboratory test. Part B covers this type of test when it is ordered to identify, evaluate, or manage a medical problem. Part A may apply when the MRI is part of a covered inpatient hospital stay.
Advanced diagnostic imaging performed outside a hospital must be provided by an accredited provider for Medicare payment. The ordering provider should identify the medical reason for the test. The imaging facility submits the technical charge, and the interpreting clinician may submit a separate professional charge.
Eligibility and limits
The scan must be reasonable and medically necessary. Local Medicare coverage rules may apply to the body area, diagnosis, use of contrast, and frequency. A repeat scan may require documentation showing why another test is needed. Sedation, contrast material, laboratory testing, and other related services have separate coverage rules.
Costs
After the Part B deductible, you generally pay 20 percent of the Medicare-approved amount for an MRI received in a doctor’s office or independent diagnostic testing facility. A hospital outpatient MRI can also include a hospital copayment. Professional interpretation and other services may be billed separately.
Medicare Advantage
Medicare Advantage plans must cover medically necessary MRI services covered by Original Medicare. Plans commonly use imaging networks and prior authorization. A referring doctor’s order does not replace plan authorization when authorization is required.
What to do next
- Ask the ordering provider to identify the reason and body area for the scan.
- Confirm accreditation, Medicare participation, and plan network status.
- Obtain prior authorization when required.
- Ask whether the facility, interpretation, contrast, and sedation will be billed separately.
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.