Does Medicare cover an EKG?

When does Medicare cover an EKG?

Medicare Part B covers an EKG or ECG (electrocardiogram), which helps find problems with your heart, in two situations:

• A routine EKG or ECG screening, if your doctor or other health care provider gives you a referral for this screening during your one-time “Welcome to Medicare” preventive visit.
• EKGs or ECGs as diagnostic tests, when your provider orders them to find or treat a medical problem.

What do I pay for an EKG with Medicare?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for an EKG in your doctor's office or an independent diagnostic testing facility. If you have the test at a hospital or a hospital-owned clinic, you also pay the hospital a copayment. For a test you get as a hospital outpatient, that copayment may be more than 20% of the Medicare-approved amount, but in most cases it can't be more than the Part A hospital stay deductible ($1,736 in 2026).

CMS lists no copayment, coinsurance or deductible for the “Welcome to Medicare” visit itself, but says the copayment or coinsurance and the deductible apply to the screening EKG.

How often does Medicare cover an EKG?

Medicare Part B covers the routine EKG screening once, during your “Welcome to Medicare” visit, and covers EKGs more often as a diagnostic test if they're medically necessary. Medically necessary means health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine. The “Welcome to Medicare” visit itself is covered once within the first 12 months you have Part B.

Is an EKG part of the yearly Wellness visit?

Medicare.gov ties the routine screening EKG to the “Welcome to Medicare” visit. At the yearly “Wellness” visit, your provider takes routine measurements like height, weight and blood pressure, and may order other tests if necessary, depending on your general health and medical history. Tests your provider performs during the same visit that Medicare doesn't cover under the preventive benefit may come with coinsurance and the Part B deductible. See what happens at a Medicare annual wellness visit.

What other heart screenings does Medicare cover?

Medicare Part B covers cardiovascular disease screening blood tests for cholesterol, lipid and triglyceride levels once every 5 years, and a cardiovascular behavioral therapy visit with your primary care doctor or other primary care practitioner once a year; you pay nothing for either if your provider accepts assignment. See whether Medicare covers cholesterol tests.

Does Medigap or Medicare Advantage change what I pay for an EKG?

Medigap (Medicare Supplement Insurance) policies help cover out-of-pocket costs in Original Medicare, like copayments, coinsurance and deductibles, for services Original Medicare covers; the benefits are different in each plan. Medicare Advantage Plans must cover all medically necessary services that Original Medicare covers, but they may have different out-of-pocket costs for certain services and may require you to use providers in the plan's network for non-emergency care.