Question 1

Does Medicare cover brain MRI?

Accepted Answer

Yes. Medicare Part B covers brain MRI (CPT 70553 with/without contrast) when medically necessary — for evaluation of neurological symptoms such as headache, cognitive changes, seizures, stroke symptoms, or dizziness. Medicare pays 80% of the approved amount; you owe 20% after your $283 annual Part B deductible. Medicare does not cover routine or screening brain MRI without clinical indication. A physician order documenting medical necessity is required.

Question 2

Is a brain MRI cheaper at a freestanding imaging center vs hospital?

Accepted Answer

Yes, substantially. The hospital outpatient department (HOPD) facility fee for brain MRI (CPT 70553) is approximately $720 (your 20%: $144). A freestanding imaging center (ASC-equivalent) charges approximately $480 (your 20%: $96). Choosing an imaging center saves $48 in coinsurance. If you have multiple MRIs per year, the savings add up. Ask your referring physician if they can send you to a freestanding imaging center — your Medicare coverage is the same at either location.

Question 3

What is the Medicare out-of-pocket cost for a brain MRI?

Accepted Answer

In 2026, the radiologist (reading) fee for brain MRI (CPT 70553) is approximately $95 nationally (your 20%: $19). The facility fee is $720 at an HOPD (your 20%: $144) or $480 at a freestanding center (your 20%: $96). Total out-of-pocket at a freestanding center without Medigap (after $283 annual deductible): approximately $115 per scan. With Medigap Plan G: $0 after the $283 annual deductible. No anesthesia is required for standard MRI.

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 — Brain MRI (CPT 70553)	$316	$63
Hospital Outpatient (HOPD) Facility Fee	$356	$71
Ambulatory Surgery Center (ASC) Facility Fee	$192	$38
Anesthesia (estimated)	none	20% of approved

Medicare Brain MRI Cost 2026 | Out-of-Pocket Estimator

2026 Medicare Cost Summary — Brain MRI (CPT 70553)

What Medicare Pays

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