Bone Mass Measurement

Medicare covers bone mass measurement (BMM) when performed with an approved BMM method (e.g., DXA, RA, sonometry, SEXA, QCT) on 'qualified individuals'—including estrogen‑deficient women at clinical risk, those with vertebral abnormalities, long‑term glucocorticoid users (≥5 mg prednisone/day for >3 months), primary hyperparathyroidism, or patients being monitored on FDA‑approved osteoporosis therapy—and when ordered and furnished by qualified personnel with physician interpretation. Routine coverage is one test every two years (≥23 months), with earlier coverage (after 11 months or annually in some cases) allowed for specific medical circumstances such as steroid monitoring, confirmatory baselines, or monitoring therapy response; tests for therapy monitoring and confirmatory baselines generally must be performed with DXA of the axial skeleton.

"BMM is covered when performed using one of the listed methods: dual energy x-ray absorptiometry (DXA), radiographic absorptiometry (RA), bone sonometry (ultrasound), single energy x-ray absorptiome..."