Minds → Medicare → Are routine screening exams like mammography or colorectal cancer screening excluded from Medicare coverage as routine checkups? Answer in under 100 words.
US FederalMedicare Part BAre routine screening exams like mammography or colorectal cancer screening excluded from Medicare coverage as routine checkups? Answer in under 100 words.
No, routine checkups are generally excluded from Medicare coverage, but specific preventive screening tests like screening mammography and colorectal cancer screening tests are exceptions to this exclusion and are covered under Medicare Part B. For colorectal cancer screening tests (excluding barium enemas), Medicare Part B pays 100 percent beginning January 1, 2030.
Last verified: 2026-08-26 · Sources checked: 2/2 resolving · Next scheduled review: 2026-11-24
Details / How it works
Under 42 CFR 411.15(a), routine physical checkups are excluded from Medicare Part A and B coverage. However, specific exceptions are made for several preventive and screening services, including screening mammography and colorectal cancer screening tests, which are covered.
Numbers & thresholds
| Service | Medicare Part B Payment Percentage | Effective Period |
|---|---|---|
| Colorectal cancer screening tests (excluding barium enemas) | 80% | CY 2022 |
| Colorectal cancer screening tests (excluding barium enemas) | 85% | CY 2023 through 2026 |
| Colorectal cancer screening tests (excluding barium enemas) | 90% | CY 2027 through 2029 |
| Colorectal cancer screening tests (excluding barium enemas) | 100% | Beginning January 1, 2030 |
| Screening mammography | 100% | (not specified in context) |
Exceptions & edge cases
Colorectal cancer screening tests have a phase-in schedule for payment percentages, reaching 100% only from January 1, 2030. Other preventive services like screening mammography are paid at 100% of the Medicare payment amount.
Sources
- [1]U.S. National Archives, Electronic Code of Federal Regulations — 42 CFR 411.15 — Particular services excluded from coverage · as of 2026-08-26
- [2]U.S. National Archives, Electronic Code of Federal Regulations — 42 CFR 410.152 — Amounts of payment · as of 2026-08-26
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