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The Mammography section provides information and resources related to the coverage, billing, delivery, and promotion of screening mammography. Medicare covers an annual screening mammogram for all women with Medicare ages 40 and older. A doctor's prescription or referral is not necessary for Medicare payment. This page provides general facts about mammography and links to other resources. General Facts Introduction: - Breast cancer is the second leading cause of cancer deaths after lung cancer.
- Every woman is at risk, and the risk of breast cancer increases with age. Approximately 94% of breast cancers are diagnosed in women over age 40 (CDC).
- Mammography is the best available way to detect breast cancer early, when it is most curable. Timely screening can reduce breast cancer mortality in women 40 and older by 17% to 30% (CDC).
- A mammogram is a low-dose x-ray of the breast which can find lumps that are too small to be felt during a clinical breast examination.
What Medicare Covers: - All women with Medicare ages 40 and older are eligible to receive a screening mammogram every 12 months. Medicare also covers digital technologies for screening mammograms.
- Medicare pays for one baseline mammogram for women with Medicare between ages 35 and 39.
- A doctor's prescription or referral is not necessary for Medicare payment of screening mammograms.
- There is no Part B deductible, but a 20% coinsurance or co-payment applies.
Other Helpful Information: - Despite Medicare coverage, mammography rates are suboptimal. In 2000, approximately 68% of women ages 65 and older reported having a mammogram within the past two years (Federal Interagency Forum on Aging-Related Statistics).
- CMS is conducting the national Medicare Mammography Campaign to improve beneficiaries' knowledge of breast cancer screening and awareness of Medicare's annual screening mammography benefit. The campaign also targets health care providers to encourage them to promote screening mammography to their patients.
Links/Resources
The links below include general information about mammography, as well as resources, which include the following: - Centers for Disease Control and Prevention's National Breast and Cervical Cancer Detection Program
- National Cancer Institute
- U.S. Preventive Services Task Force
Page Last Modified: 10/14/2008 8:00:32 AM
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