Does Medicare Cover a Colonoscopy?

Yes, Part B, the part of Medicare that pays for doctor visits, pays for colonoscopies that check for colon cancer. A colonoscopy uses a thin tube with a camera to look for growths called polyps. If you've put off this test over the prep or the cost, it helps to know what you'll pay. You pay nothing for the screening if your doctor accepts assignment. You may owe a share if a polyp is removed.

You pay $0 if

• Your doctor and the place where you have the test accept Medicare assignment.
• It's a screening, and you're due for one.
• No polyp or tissue is removed.

Not sure Medicare will pay? Ask anyway, because the doctor's office can tell you if you're due and what it will cost. If you would rather not make the calls, a Pair Team advocate can help.

Colon cancer screening tests Medicare pays for (2026)

You and your doctor can choose the right test for you.

How often does Medicare pay for a colonoscopy?

Medicare pays for a colonoscopy once every 10 years if you're at average risk. If you had a flexible sigmoidoscopy, another kind of screening, Medicare pays for a colonoscopy 4 years after it.

If you're at high risk, Medicare pays for one every 2 years. Your doctor decides your risk. You're not at average risk if you've had certain polyps, colon cancer or inflammatory bowel disease, Medicare.gov says. A family history of colon cancer or certain polyps counts too.

There is no minimum age for a screening colonoscopy, and Medicare.gov lists no top age. The stool DNA test and the blood test are only for people 45 to 85.

What do I pay if a polyp is removed?

If a polyp is removed, you pay 15% of Medicare's approved amount for the doctor in 2026. If the test is at a hospital outpatient department or a surgery center, you also pay the facility 15%. The deductible still doesn't apply, Medicare.gov says.

Your share is going down, and under federal law it is:

• 15% through December 31, 2026
• 10% in 2027, 2028 and 2029
• Nothing starting January 1, 2030

You may get one bill from the doctor and another from the facility. Before the test, ask both offices what you'd owe if a polyp is removed.

What if my home test comes back positive?

If your home test comes back positive, Medicare pays for the colonoscopy that follows as a screening. You pay $0 if the doctor accepts assignment. This applies after a positive stool test, stool DNA test or blood test that Medicare covered. The usual 10-year wait doesn't apply here, says the Centers for Medicare & Medicaid Services (CMS), the federal agency that runs Medicare. If a polyp is removed during that colonoscopy, you may still owe the polyp share.

How to get a screening colonoscopy

1. Talk with your doctor. Ask if you're due and which test fits you. You can also check your past screenings by logging in to your Medicare account.
2. Ask the doctor and the facility, "Do you accept Medicare assignment?"
3. Ask for two prices, so a bill doesn't surprise you. Get one with no polyp and one if a polyp is removed.
4. Plan your ride home, because you can't drive until the medicine to make you sleepy wears off. Set up a ride first, the National Institutes of Health says. See help with rides to medical appointments.
5. Check your Medicare Summary Notice, and if you were billed for the screening itself, call the office. If Medicare denied it, you can appeal.

Your doctor may also bring up screening at your yearly wellness visit, which is also $0 with a doctor who accepts assignment.

If you have Medicaid or a Medicare Advantage plan

Qualified Medicare Beneficiary (QMB) or Medicaid: QMB is one of the Medicare Savings Programs. If you have QMB, providers can't bill you for Medicare copays. That includes the 15% share. See having Medicare and Medicaid together.

Medicare Advantage: Plans must cover what Original Medicare covers, Medicare.gov says, but you may need approval first. Call your plan before the test. Ask which doctors and facilities are in the network, and what you pay if a polyp is removed.

What a Pair Team advocate does

People who call us about a colonoscopy often need a ride home after the test. Others need help with a bill that came later. This is what we do:

• Find a doctor and facility that accept Medicare assignment, and ask what it will cost before the test.
• Set up a ride home after the test.
• Look over the bill and your Medicare notice, and call the office if the screening was billed by mistake.
• Help with what usually comes with it: prescriptions, food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Does Medicare pay for the anesthesia?

Yes, you pay nothing for anesthesia during a screening colonoscopy, CMS says. If a polyp is removed, the anesthesia bill may also carry the 15% share in 2026.

What if I have symptoms, like bleeding?

If you have symptoms, like bleeding, the test may be billed as a diagnostic colonoscopy instead of a screening. In that case you may pay 20% after the $283 deductible in 2026. Ask the office how it will be billed.

What if my doctor wants me to have one sooner than 10 years?

If your doctor wants one sooner, ask if you count as high risk. A doctor may suggest a service more often than Medicare covers, Medicare.gov warns. If so, you may pay for it.

What if the doctor does not accept assignment?

If the doctor doesn't accept assignment, you may owe part of the bill. A doctor who takes Medicare but does not accept assignment can usually charge up to 15% more than Medicare's price. You may have to pay at the visit, so ask before you book.

Do I need a referral?

For the home stool test, you need an order from your doctor, a nurse practitioner or a physician assistant, Medicare.gov says. For a colonoscopy in Original Medicare, you usually don't need a referral to see a specialist.

Sources

• Colonoscopies (screening), Medicare.gov
• Fecal occult blood tests (screening), Medicare.gov
• Multi-target stool DNA tests (screening), Medicare.gov
• Blood-based biomarker tests for colorectal cancer (screening), Medicare.gov
• Computed tomography (CT) colonography (screening), Medicare.gov
• MLN006559 Medicare Preventive Services: Colorectal Cancer Screening, CMS
• 42 U.S.C. 1395l(dd), special coinsurance rule for colorectal cancer screening tests, Legal Information Institute
• Preventive & screening services, Medicare.gov
• Colonoscopy, National Institute of Diabetes and Digestive and Kidney Diseases
• Does your provider accept Medicare as full payment?, Medicare.gov
• Compare Original Medicare and Medicare Advantage, Medicare.gov
• Qualified Medicare Beneficiary (QMB) Program, CMS
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS
• Colorectal cancer screenings, Medicare Interactive