Medicare Breast Ultrasound Policy Change

Today’s video reports on a Medicare reimbursement policy change. Previously, Medicare would pay for a breast ultrasound for a woman with a diagnosis of “dense breasts.” This remains fairly routine in the commercial sector. However, last year Medicare’s policy changed. Medicare will cover a breast ultrasound for a specific system or concern, a suspected lump and for patients with a history of breast cancer. But, as noted above, a diagnosis of dense breasts alone will be insufficient for Medicare to pay for the procedure.

Women will need to discuss this change with their doctors because their decision will be to forego the breast ultrasound or to pay out-of-pocket. 

We know this type of change creates stress for those accustomed to having a breast ultrasound on a routine basis for dense breasts. And we hope the research that indicates a breast ultrasound is not necessary for those with dense breasts is compelling enough to support this change in coverage. Again, we urge all those affected to discuss this issue with their doctor or doctors so that you make a decision with which you are comfortable. Thank you.