Does Medicare Cover Echocardiograms (ECG)?

Key takeaways

• Original Medicare (Parts A and B) or Medicare Advantage (Part C) generally covers echocardiograms (ECGs) when they’re medically justified.
• Median charges for an ECG range from $204 to $2,588, and Medicare beneficiaries usually pay less than people with commercial insurance or no coverage.
• Medicare Part A covers ECGs performed during inpatient stays, Part B covers outpatient tests after the deductible is met, and Part C plans may require using in-network providers for full benefits.

Medicare pays for diagnostic procedures that are medically necessary, which includes echocardiograms (ECGs). Still, you may face some out-of-pocket expenses depending on your coverage and where the test is administered.

Your precise cost-sharing and coverage depend on whether the test is billed under Part A, Part B, or a Medicare Advantage plan.

How often does Medicare cover an echocardiogram?

Medicare will cover an echocardiogram when it’s considered medically necessary as follows:

• Part A: If you’re an inpatient, Part A (hospital insurance) will cover tests ordered by your physician during your hospital stay, including an echocardiogram.
• Part B: Part B covers outpatient services. If an echocardiogram is ordered during your one-time “Welcome to Medicare” preventive visit , Part B will pay for it. After that visit, Part B covers the test only when it’s medically necessary (for example, if you have chest pain).
• Part C: Medicare Advantage (Part C) plans cover echocardiograms similarly to Original Medicare, though some plans may broaden coverage to additional indications.

What is the average cost for an echocardiogram?

A 2022 analysis of U.S. hospitals reported median echocardiogram prices between $204 and $2,588. A 2023 study also showed that people who paid without insurance or with commercial insurance paid about 2.93 and 3.06 times more , respectively, than Medicare-covered patients.

Your Medicare-related costs for an echocardiogram vary by which part or plan covers it:

• Part A: The charge for an echocardiogram counts toward your Part A deductible, which in 2025 is $1,676  per benefit period. After meeting that deductible, Part A covers tests and procedures during your hospital stay for the first 60 days.
• Part B: Once you’ve paid the $257 deductible, Medicare pays 80% of the approved amount for the echocardiogram; you’re responsible for the remaining 20%.
• Part C: Coverage often requires using in-network providers to receive full benefits. Deductibles and premiums vary by plan.

Medigap

Medigap (Medicare Supplement Insurance) can pick up many of your out-of-pocket costs from Original Medicare, such as Part A and Part B deductibles, copayments, and coinsurance.

That means a Medigap policy can help cover the expenses you would normally owe for an echocardiogram.

Keep in mind Medigap plans charge a monthly premium in addition to your Medicare Part A or B premiums. While you’ll pay more each month, the policy can reduce or eliminate costs when you need services like an echocardiogram.

Does an echocardiogram require prior authorization with Medicare?

In some cases, a provider must get Medicare approval before providing certain services — this is known as prior authorization.

You generally won’t need prior authorization for an echocardiogram under Parts A or B, but some Medicare Advantage plans may impose that requirement. It depends on the insurer offering your Part C coverage.

Regardless, you typically must have the test performed at a facility that accepts Medicare, and the clinician performing the echocardiogram must participate in Medicare as well. You can search for participating providers on the Medicare website . If the provider doesn’t accept Medicare, you may be billed the full amount.

Medicare Advantage plans may also differentiate between in-network and out-of-network services. Some plans provide no out-of-network benefits even if the facility accepts Medicare.

Receiving care out of network usually means higher out-of-pocket costs.

The bottom line

Part A covers echocardiograms performed during a hospital stay, and Part B covers them when provided on an outpatient basis. Medicare Advantage (Part C) also covers echocardiograms but typically requires staying within the plan’s network for full benefits.

If Medicare denies coverage for an echocardiogram that you believe was medically necessary, you have the right to file an appeal to explain why the test should be covered.