Does Medicare cover a colonoscopy?
Usually covered
Medicare Part B fully covers screening colonoscopies as preventive care with no cost to you, though a biopsy or polyp removal during the exam can add a small coinsurance.
- Not when A polyp is removed or a biopsy is taken during the screening — you may owe coinsurance on the therapeutic portion.
- Not when The colonoscopy is diagnostic (ordered because of symptoms or a positive prior test), not a routine screening — normal Part B cost-sharing applies.
What flips the answer
- Not covered when
A polyp is removed or a biopsy is taken during the screening — you may owe coinsurance on the therapeutic portion.
- Not covered when
The colonoscopy is diagnostic (ordered because of symptoms or a positive prior test), not a routine screening — normal Part B cost-sharing applies.
- Not covered when
You get screened more often than the covered interval (24 months high-risk / 120 months average-risk) without a qualifying reason.
Key facts
- Verdict
- Usually covered
- Applies to
- colonoscopy · Medicare
- Not covered when
- A polyp is removed or a biopsy is taken during the screening — you may owe coinsurance on the therapeutic portion.
- Verified
- 2026-07-03 · 1 primary source
Medicare Part B covers screening colonoscopies to catch colorectal cancer early. As a preventive service, there's no deductible and no coinsurance for the screening itself when the provider accepts assignment.
How often depends on risk. If you're at high risk for colorectal cancer, Medicare covers a screening colonoscopy once every 24 months. If you're not high risk, it's covered once every 120 months (or 48 months after a screening flexible sigmoidoscopy).
There's a well-known catch. If the doctor finds and removes a polyp or takes a biopsy during a screening colonoscopy, the procedure can be billed with a therapeutic component. In that case you may owe coinsurance for the polyp removal, though the Part B deductible still doesn't apply to it.
A colonoscopy done to investigate symptoms — bleeding, pain, a positive stool test follow-up — is diagnostic rather than screening, and standard Part B cost-sharing (20% after the deductible) generally applies.
What people typically pay
For a routine screening colonoscopy with a provider who accepts assignment, you pay nothing — no deductible and no coinsurance. If a polyp or other tissue is removed, you pay 15% of the Medicare-approved amount for your provider's services, plus an additional 15% facility coinsurance in a hospital outpatient setting or ambulatory surgical center. The Part B deductible doesn't apply.
Without coverage, colonoscopy costs vary widely by region, facility type, and whether polyps are removed. Ask your provider for an estimate before scheduling.
The single biggest swing in cost is whether the exam stays purely a screening or becomes diagnostic/therapeutic when tissue is removed.
How to actually get it covered
Confirm your risk category and timing — check whether you're average risk (covered every 120 months) or high risk (every 24 months), and that enough time has passed since your last screening.
Choose a provider who accepts Medicare assignment, and confirm the facility does too, so the screening is billed with no cost-sharing.
Tell the scheduler explicitly that this is a preventive screening colonoscopy, not a diagnostic one, so it's coded correctly from the start.
Ask in advance how the practice bills if a polyp is found — get their policy on the therapeutic coinsurance in writing if possible.
After the procedure, review your Medicare Summary Notice or Explanation of Benefits to confirm the screening was processed at $0 and any polyp charge was billed correctly.
If you're wrongly charged for the screening portion, call the billing office to have it recoded, and contact 1-800-MEDICARE if the error isn't corrected.
Common questions
Why did I get a bill after a colonoscopy that was supposed to be free?
The most common reason is that the doctor found and removed a polyp or took a biopsy during the exam, which turns the visit into a partly therapeutic procedure. When that happens, Medicare applies a coinsurance to the removal portion — you pay 15% of the Medicare-approved amount for your provider's services, plus another 15% facility coinsurance in a hospital outpatient setting or ambulatory surgical center. The Part B deductible still won't apply. So the screening stays free, but the polyp work adds a charge.
How often will Medicare pay for a screening colonoscopy?
If you're at high risk for colorectal cancer, Medicare covers a screening once every 24 months. If you're average risk, it's covered once every 120 months, or 48 months after a screening flexible sigmoidoscopy. Getting screened more often than these intervals without a qualifying reason means you'd pay out of pocket.
Is a colonoscopy to check symptoms covered the same as a screening?
No. A colonoscopy ordered because of bleeding, pain, or a positive stool test is considered diagnostic, not preventive. That means standard Part B cost-sharing applies — you pay 20% of the approved amount after meeting your deductible. Note that if you have a Medicare-covered stool-based test or blood-based biomarker test come back positive, the follow-up colonoscopy is still covered as a screening.
Does the bowel prep or anesthesia cost extra with a screening colonoscopy?
You pay nothing for the screening test itself when your provider accepts assignment, though other costs may apply. Charges for items like prep medications or anesthesia can vary, and specific amounts you could owe depend on other insurance you have, what your doctor charges, and the type of facility. If a polyp or tissue is removed, coinsurance applies to that portion. Ask your provider in advance how much your test will cost.
What if I have a Medicare Advantage plan instead of Original Medicare?
Medicare Advantage plans must cover at least what Original Medicare covers, so the screening itself should be covered. However, network rules, prior authorization, and the way the plan handles polyp removal can differ. Check your plan's specific rules before scheduling.
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