Bone mass measurements, also known as bone density studies, are used to identify bone mass, detect bone loss, determine bone quality, and evaluate diseases of the bone and their responses to treatment. This section provides information and resources on Medicare's bone mass measurements benefit.

Introduction: 

• An estimated 10 million Americans have osteoporosis.
• 34 million Americans have low bone mass, placing them at an increased risk for osteoporosis.
• Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures of other sites. 
• Osteoporosis can be prevented. Early diagnosis and treatment can reduce or prevent fractures from occurring.

 What Medicare Covers

• Medicare covers bone mass measurements every 2 years for "qualified" individuals considered to be at risk for osteoporosis. A "qualified" individual means a Medicare beneficiary who meets the medical indications for one of the following five categories:

1. An estrogen-deficient woman
2. An individual with vertebral abnormalities
3. An individual with known primary hyperparathyroidism
4. Some individuals receiving steroid therapy
5. Individuals receiving FDA-approved osteoporosis drug therapy

NOTE: If medically necessary, Medicare may provide coverage for a beneficiary more frequently than every 2 years.

• Other criteria must be met for bone mass measurement to be covered by Medicare. These criteria are described in more detail in "Provider Resources" in this section.
• The beneficiary pays 20% of the Medicare approved amount after meeting the yearly Part B deductible.

 Other helpful information:

CMS has developed several resources to help communicate with beneficiaries and providers about the bone mass measurement benefit. In addition, there are several organizations that provide information on bone diseases, such as osteoporosis. Links to general resources on osteoporosis and bone health are available below. Links to information and resources to help communicate with beneficiaries about this benefit are available in the "Beneficiary Resources" page of this section. Links and resources to communicate with providers about this benefit are available in the "Provider Resources" page in this section of the website.

In addition, the National Institutes of Health Osteoporosis and Related Bone Diseases National Resources Center provides patients, health professionals, and the public with an important link to resources and information on osteoporosis and other metabolic bone diseases.  The Center has a wide range of publications and fact sheets on topics including osteoporosis in men and various ethnic groups, prevention of falls and fractures, calcium supplements, exercise, and quality-of-life issues.  In addition, a report titled, "Bone Health and Osteoporosis: A Report of the Surgeon General" and an accompanying booklet written for the general public are available at their website listed in the "Related Links Outside CMS" section below.

Downloads
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Related Links Inside CMS
There are no Related Links Inside CMS.
Related Links Outside CMS
NIH Osteoporosis and Related Bone Diseases National Resource Center National Osteoporosis Foundation

Page Last Modified: 02/03/2009 9:57:59 AM
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