How much will Medicare cover for an MRI?

Asked by: Juliet Krajcik  |  Last update: February 17, 2026
Score: 4.1/5 (48 votes)

Medicare typically covers 80% of the Medicare-approved amount for a medically necessary MRI after you've met your Part B deductible, leaving you responsible for the remaining 20% and any facility copays, though costs vary by location and provider, with Medigap plans often covering the leftover costs. Coverage requires the MRI to be ordered by a doctor for diagnosis or treatment, not just prevention, and the imaging center must accept Medicare assignment.

How much does Medicare cover on an MRI?

This may help doctors diagnose conditions that affect those areas. Medicare Part B may cover 80% of the cost for a medically required magnetic resonance imaging (MRI) scan ordered by a doctor. However, both the doctor and the facility performing the scan must accept Medicare patients.

Does MRI get covered by Medicare?

Only specific MRI services listed on the MBS are eligible for a Medicare rebate, and therefore bulk billing. Even if your scan is performed on a fully licensed MRI machine, Medicare rebates only apply when specific MBS criteria are met.

How much is the out of pocket cost for an MRI?

An MRI out-of-pocket cost varies greatly, from potentially $200-$500 at discount imaging centers for a self-pay scan to several hundred or even thousands of dollars with insurance (depending on deductibles/copays) or paying full price at a hospital, with averages often falling around $400 to over $2,000 for uninsured patients, and complex scans costing more. Factors like location, facility (hospital vs. imaging center), scan type (with/without contrast), and insurance status heavily influence the final price, making shopping around crucial. 

Why would Medicare not pay for MRI?

For Medicare to cover an MRI, you'll need to meet certain requirements. Here's how it works: Your magnetic resonance imaging (MRI) must be deemed medically necessary by a doctor or provider that accepts Medicare.

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Can I negotiate the price of an MRI?

Yes, you may be able to negotiate lower MRI costs by asking for discounted payment options or self-pay rates.

How much does an MRI scan cost?

An MRI scan in the U.S. can cost anywhere from $400 to over $12,000 without insurance, averaging around $1,300-$2,000, with prices varying significantly by body part (brain, knee, abdomen), location (hospital vs. imaging center), and if contrast dye is used (+$100-$500). Insured costs are lower, typically $50-$500 out-of-pocket, but depend on your deductible and plan, while hospitals often charge more than independent centers due to facility fees.
 

What is the cheapest way to get an MRI?

The cheapest way to get an MRI involves using independent imaging centers, choosing self-pay/cash rates (often cheaper than insurance for high deductibles), using discount platforms like MDsave or Sesame, and comparing prices between hospitals and freestanding clinics to avoid high hospital overhead. Always get a pre-authorization to understand costs and negotiate cash prices upfront for significant savings. 

Why won't insurance pay for MRI?

Insurance denies MRIs primarily for lack of "medical necessity," meaning they believe less costly options (like X-rays, CT scans, or physical therapy) haven't been tried or aren't sufficient, or due to administrative issues like missing prior authorization, coding errors, or provider network limits. Insurers aim to control costs, so they scrutinize advanced imaging, requiring strong justification that the MRI is crucial and will change treatment, not just confirm symptoms. 

How to get a free MRI?

To get a free or low-cost MRI, look into charitable programs like MSAA for MS patients or RadiologyAssist for financial hardship, explore clinical trials at universities, use crowdfunding platforms like GoFundMe, or find independent imaging centers with self-pay cash rates, which are often cheaper than using insurance if you have a high deductible, notes Burbank Imaging and Open MRI and Sesame Care. In the UK, an MRI is free with an NHS referral, though waits can be long. 

Does Medicare require a prior authorization for MRI?

Whether you have Original Medicare or Medicare Advantage, you should not need prior authorization for an MRI. However, you can confirm this by speaking with Medicare or your plan provider directly.

What procedures are not covered by Medicare?

Some of the items and services Medicare doesn't cover include:

  • A heart valve repair or replacement.
  • An organ transplant.
  • Cancer-related treatments.
  • Dialysis services for the treatment of End-Stage Renal Disease (ESRD)

How to find out if MRI is covered by insurance?

Yes, your insurance likely covers MRIs if they are medically necessary, but coverage varies by plan, requiring pre-authorization and potentially involving your deductible, copay, or coinsurance, so you must contact your provider to confirm details like required networks or prior approvals for your specific situation. Full-body MRIs are typically not covered as they're considered elective.
 

Can MRI scans be claimed on Medicare?

Key takeaways

Medicare covers MRI scans when a doctor deems them medically necessary to diagnose a disease or medical condition. For outpatient scans, Medicare Part B covers 80% of costs after a person meets their deductible. During a hospital stay, Part A covers all eligible costs once a person meets their deductible.

What happens if you can't afford an MRI?

If you need an MRI but can't afford it, contact the imaging center for payment plans or discounts, ask your doctor about alternative scans (X-ray, ultrasound), check for hospital charity care or nonprofit programs, explore low-cost MRI services like Radiology Assist or MDsave, look into university research studies, or consider crowdfunding. Always discuss your situation with your provider and facility to find solutions like cash prices that can be much lower than billed rates.
 

What disqualifies you from getting an MRI?

Magnetic fields in MRI scanners can trigger 5 critical interactions in patients with metallic foreign bodies, including projectile motion, implant displacement or twisting, tissue burns, imaging artifacts, and device malfunction (eg, pacemaker interference).

What do I do if my insurance denies my MRI?

If your insurer has denied your claim for an MRI, your doctor can contact the insurance company and request that it reconsiders the denial. Your doctor may also make a request to speak with the medical reviewer of the insurance plan as part of a “peer-to-peer insurance review,” to challenge the decision.

How much would an MRI be out of pocket?

An MRI out-of-pocket cost varies greatly, from potentially $200-$500 at discount imaging centers for a self-pay scan to several hundred or even thousands of dollars with insurance (depending on deductibles/copays) or paying full price at a hospital, with averages often falling around $400 to over $2,000 for uninsured patients, and complex scans costing more. Factors like location, facility (hospital vs. imaging center), scan type (with/without contrast), and insurance status heavily influence the final price, making shopping around crucial. 

What is the cost of a full MRI scan?

A full MRI scan cost varies widely, from around $2,000 to $3,000+ for a preventative full-body screening, often paid out-of-pocket, while medically necessary MRIs for specific body parts range from a few hundred to several thousand dollars, averaging around $1,325 nationally but highly dependent on location and body area scanned. Expect to pay more for comprehensive screenings (head, neck, chest, abdomen, pelvis) compared to scans for just one area.
 

Can I negotiate MRI cost?

Another way to save money on your MRI is to negotiate directly with the imaging center. Depending on the location, they may be able to give you a lower rate. It pays to shop around because you'll know what other providers are charging, and one center may offer you a lower rate to earn your business.

Is it worth paying for a private MRI?

Many people consider getting private scans to save time and avoid excruciating delays. However, the decision is not entirely straightforward for most. While getting an MRI scan via the NHS is much cheaper, the long wait to get one offsets the savings, especially during times of urgent need.

Does insurance usually cover MRI costs?

An MRI is generally covered by insurance when it is deemed medically necessary. However, insurance coverage for MRIs can vary based on your circumstances as well as the insurance plan.

What should I tell my doctor before an MRI?

Here's what to do before an MRI.

  • Let Your Doctor Know If You Have Claustrophobia. ...
  • Leave Your Jewelry at Home. ...
  • Be Honest With Your Doctor. ...
  • Don't Get Any New Piercings. ...
  • Don't Disregard Doctor's Instructions. ...
  • Don't Disrupt Your Schedule. ...
  • Arrive Early. ...
  • Get Prepared.

How to lower the cost of an MRI?

Here are a few suggestions:

  1. If you have insurance, always contact them to verify your MRI is covered.
  2. Consider the out-of-pocket costs to see if skipping insurance is more cost-effective.
  3. Avoid MRIs at hospitals or emergency rooms when possible.
  4. Schedule a scan at an independent imaging clinic.

What does an MRI show that a CT scan does not?

An MRI excels at showing detailed differences between soft tissues like the brain, spinal cord, ligaments, and cartilage, revealing subtle issues like torn tendons, herniated discs, or early tumors that CT scans often miss, whereas CT is better for bone detail and quick checks for internal bleeding or fractures. MRI uses magnets and radio waves, while CT uses X-rays, meaning MRI provides superior soft tissue contrast without radiation but takes longer, making CT better for emergencies.