Key takeaways:
Original Medicare and Medicare Advantage both cover medically necessary MRIs. But the scans must meet a few requirements.
Medicare Part B will cover 80% of the Medicare-approved amount for an authorized MRI. But you will need to pay your annual deductible before Medicare pays its part of the scan.
You may be eligible for Medigap supplemental insurance with original Medicare. Medigap helps cover out-of-pocket costs like deductibles, copays, and coinsurance.
If you are dealing with pain, it’s important to contact your healthcare professional. First, they may recommend blood work, X-rays, and CT scans. But these tests don’t always provide a clear answer. So the next step may be to order an MRI to help identify what is causing your symptoms.
While MRIs are effective tools for diagnosing unseen conditions, they are rarely cheap. The cost can vary based on the body part that is being scanned, location of the facility conducting the MRI, and the healthcare professional.
Fortunately, if you have Medicare, you most likely won’t have to cover the total cost of your MRI if it meets certain requirements.
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What is an MRI?
MRI stands for magnetic resonance imaging. Healthcare professionals use this diagnostic test to identify and treat internal injuries and illnesses.
MRIs are noninvasive and painless. They work by using powerful electromagnets, computer technology, and radio waves. Together, these tools create detailed three-dimensional pictures of the inside of your body.
MRIs work well for viewing soft tissues, like those that make up the brain and spinal cord. They don’t use potentially harmful ionizing radiation like X-rays and CT scans do. But that doesn’t mean they are risk-free.
Like CT scans, MRIs can be done with or without contrast, a technique that involves using dye to highlight internal organs and tissues. This dye can lead to allergic reactions, as well as severe injury to the kidneys in some cases.
And while MRIs may show much finer detail than X-rays and CT scans, they are also typically more expensive.
Why would you need an MRI?
An MRI can help your healthcare professional diagnose, treat, or rule out an illness or condition. These scans provide images with superior detail for certain types of tissue, including:
Muscles
Tendons
Cartilage
Adipose tissue
Nerves
Blood vessels
How much does an MRI cost? While the body part being scanned and your location play a role, several other factors can influence the price you pay for an MRI.
How much does a CT scan cost? A CT scan typically costs less than an MRI, but here are some factors that will affect how much you pay.
Got Medicare? You may already know that Medicare covers visits with healthcare professionals, but here are items it covers that you may not be aware of.
For example, suppose you are experiencing unexplained lower back pain and numbness in your legs. A CT scan or an X-ray may not provide enough information to identify the cause of your pain. So an MRI may be used to take a closer look at the nerves in your lumbar spine and find the answer.
MRIs can be particularly helpful for diagnosing conditions such as:
Very small tumors
Strokes that are too small to see on a CT scan
Infections, inflammation, and swelling
Sports injuries, like tendon and ligament tears
Various brain and spinal cord conditions
Abnormalities in blood vessels, like vasculitis, aneurysms, and dissections
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How much does an MRI cost?
The cost of an MRI can vary based on several different factors. Prices can range from as little as $400 to over $12,000. Factors that can determine the actual amount you pay include:
Body part scanned: MRI costs can vary based on the body part that needs to be examined, and some areas of the body are more expensive to scan than others.
Contrast dye: If your healthcare professional orders an MRI with contrast, that will affect your total costs.
Geography: You’ll pay more for an MRI in certain regions of the country.
Network status: If you visit an in-network facility, your costs will be negotiated by your insurance company.
Place of service: You may have your MRI at a freestanding clinic or in an inpatient hospital setting, emergency room, or other facility. The type of facility you go to will affect your costs.
Radiologist fee: A radiologist will review and read the results of your MRI, and they typically charge a separate fee for these services.
Type of insurance: There are different costs to consider depending on whether you have Medicare, commercial insurance, or supplemental insurance. If you don’t have health insurance, you’ll have to pay the full price of the MRI.
Sedatives: Your healthcare provider may prescribe you a sedative medication like Xanax, Phenobarbital, or Fentanyl prior to your exam. These medications are sometimes recommended to help keep someone calm, relaxed, and still during the exam.
Type of MRI: Open MRIs tend to be less expensive than closed MRIs because the machines are more affordable to buy and maintain. A closed MRI surrounds the body, while an open MRI is less confining.
Does Medicare cover MRIs?
Yes, your MRI may be covered under original Medicare, which is offered by the federal government. Original Medicare consists of:
Part A (hospital insurance)
Part B (medical insurance)
If you’re admitted to the hospital and need an MRI, it’s covered under Part A. In an outpatient setting, Part B covers diagnostic nonlaboratory tests like MRIs, CT scans, PET scans, and X-rays. However, your MRI must meet the following three requirements to be covered in either an inpatient or outpatient scenario:
It must be medically necessary for treating your condition.
Your healthcare professional must accept Medicare.
It must be done at a facility that accepts Medicare.
How much of the cost of an MRI does Medicare cover?
Medicare Part A covers inpatient treatments (at Medicare-accepting hospitals and facilities) that are ordered by a healthcare professional. It covers 100% of MRI costs for the first 60 days of a hospital stay. But you must first meet the Part A deductible, which is $1,676 in 2025.
Part B benefits generally cover 80% of an authorized MRI once the deductible, which is $257 in 2025, is met. You will still need to pay the remaining 20% coinsurance based on the Medicare-approved amount.
The Medicare-approved amount is a contracted rate between Medicare and healthcare professionals. If your healthcare professional or supplier accepts Medicare assignments, they agree to the payment amount Medicare allows for that service.
One way to reduce your out-of-pocket MRI costs is with Medigap supplemental insurance. These plans help fill in the benefit gaps of original Medicare and are sold by private insurers. They can help cover deductibles, copayments, and coinsurance.
The chart below includes a basic summary of MRI coverage under Medicare.
Medicare plan type | MRI coverage benefits |
|---|---|
Part A (inpatient hospital coverage) | It covers 100% of the costs for the first 60 days of a hospital stay, after your deductible is met. After Day 60, you pay coinsurance. |
Part B (outpatient medical coverage) | It covers 80% of your approved costs after your deductible and benefit criteria are met. |
Part C (Medicare Advantage) | Depending on the scenario, it covers the same costs as Part A or Part B. It may also cover the cost of prescription medications, like sedatives. |
Part D (prescription medication coverage) | Medication coverage varies depending on your plan and your income. |
Medigap (supplemental insurance) | It can cover some or all of the remaining out-of-pocket costs that original Medicare does not cover. Coverage varies by plan. |
The Centers for Medicare and Medicaid Services (CMS) also provides a search tool to help you determine your out-of-pocket costs for an MRI. For instance, an MRI brain scan without contrast averages $38 at an ambulatory center. But the same scan costs around $61 in a hospital outpatient department. These prices do not include physician fees, and you could pay more or less based on your location.
Do Medicare Advantage plans cover MRI costs?
Yes, Medicare Advantage plans generally cover approved MRI costs. Medicare Advantage plans, known as Medicare Part C, must include Part A and Part B benefits. Some may also include Part D (prescription medication coverage).
Even though Medicare Advantage plans are sold through private insurers, they are still approved by Medicare. That means they have to cover the same basic benefits as original Medicare. But their rules can differ depending on the insurer. So you should contact your plan provider and review your policy documents to understand the specifics of your coverage before your MRI.
Does Medicare require prior authorization for MRIs?
Yes, in some cases, prior authorization is necessary to get coverage for an MRI. Initially, original Medicare did not ask for prior authorization if the other requirements were met. But the Protecting Access to Medicare Act (PAMA) of 2014 changed the rules. As a result, a healthcare professional must consult a clinical decision support mechanism (CDSM) before ordering an MRI. The CDSM determines if the MRI is appropriate for the condition of the person being treated.
Medicare uses appropriate use criteria (AUC) for MRI approvals. This ensures Medicare beneficiaries do not receive unnecessary tests, services, or charges.
When does Medicare not cover an MRI scan?
Generally, MRIs will not be approved for coverage when other, less complex tests are deemed to be more appropriate.
Safety is a factor in that decision. MRIs use powerful magnets. So any metal or electronic device in your body can pose a potential hazard. It’s important to be upfront with your healthcare professionals about any conditions you may have or devices in your body to ensure an MRI is safe for you.
Medicare may approve noncovered MRI requests on a case-by-case basis.
Does Medicare cover CT scans?
Yes, Medicare Part B covers CT scans when they’re ordered by healthcare professionals to help diagnose or treat a medical condition. After meeting your Part B deductible, you’ll typically pay 20% of the Medicare-approved amount for a CT scan and other covered diagnostic tests you get in an outpatient setting. The scan must be considered medically necessary and performed by a healthcare professional who accepts Medicare.
The bottom line
Medicare covers medically necessary MRIs when they meet certain requirements. But there are still some out-of-pocket costs you may need to budget for.
The total amount you pay for an MRI will depend on a variety of factors, such as the body part being scanned, where the scan is conducted, and the medication needed for the procedure. If you have a Medigap policy, it can help reduce the out-of-pocket costs — like deductibles, copays, and coinsurance — that original Medicare doesn’t cover.
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References
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Medicare.gov. (n.d.). Diagnostic non-laboratory tests.
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Peschke, E., et al. (2021). Metallic implants in MRI - Hazards and imaging artifacts. RöFo.
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