Does Medicare cover a colonoscopy?
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.
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.
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.
That's the general answer. Yours is written in your actual policy.
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