Question 1

Does Medicare cover CT scan of the head/brain?

Accepted Answer

Yes. Medicare Part B covers CT head without contrast (CPT 70450) for evaluation of headache, head injury, stroke symptoms, neurological deficits, or syncope. Medicare pays 80% of the approved amount; you owe 20% after the $283 annual Part B deductible. CT head with contrast (CPT 70460) or without/with contrast (CPT 70470) is also covered when clinically indicated. CT head is one of the most frequently ordered Medicare imaging studies — over 3 million performed annually.

Question 2

What is the Medicare out-of-pocket cost for a CT head scan?

Accepted Answer

In 2026, the radiologist fee for CT head (CPT 70450) is approximately $55 nationally (your 20%: $11). The facility fee is $410 at an HOPD (your 20%: $82) or $270 at a freestanding imaging center (your 20%: $54). Total out-of-pocket at a freestanding center without Medigap: approximately $65. With Medigap Plan G: $0 after the $283 annual deductible. CT head is typically performed in an emergency room or hospital setting when ordered urgently, but outpatient scheduling at a freestanding center is available for non-urgent indications.

Question 3

Is a CT scan covered under Medicare Part A or Part B?

Accepted Answer

It depends on the setting. If you are a formal inpatient (admitted under Part A), CT scans are included in the bundled DRG hospital payment — no separate imaging bill. If you are outpatient (HOPD, emergency room under observation, or freestanding imaging center), CT is a Part B service: Medicare pays 80%, you pay 20% after the deductible. Observation status patients are billed under Part B, which is why observation status can be more expensive than formal inpatient admission for patients without Medigap.

Question 4

Why does this calculator show a different amount than Medicare.gov's cost estimate?

Accepted Answer

This calculator may show a higher number than Medicare.gov's "Patient Pays (average)" for several reasons: (1) Deductible timing — this calculator applies the $283 Part B annual deductible if it has not yet been met; Medicare.gov's average assumes many patients have already satisfied theirs. (2) Location adjustment — the radiologist's reading fee is adjusted by your region's Geographic Practice Cost Index (GPCI); in high-cost areas, reading fees run above the national rate. The facility fee is nationally fixed by CMS and should match Medicare.gov exactly. (3) Patient mix — Medicare.gov's "Patient Pays" average includes Medigap enrollees who pay $0 coinsurance, which pulls the reported average below what uninsured Original Medicare patients typically pay. No separate anesthesia bill applies to standard MRI or CT scans.

Cost Component	Medicare-Approved Amount	Your Share (20%)
Surgeon Fee — CT Head / Brain (CPT 70450)	$106	$21
Hospital Outpatient (HOPD) Facility Fee	$106	$21
Ambulatory Surgery Center (ASC) Facility Fee	$57	$11
Anesthesia (estimated)	none	20% of approved

Medicare CT Head / Brain Cost 2026 | Out-of-Pocket Estimator

2026 Medicare Cost Summary — CT Head / Brain (CPT 70450)

What Medicare Pays

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