A Coronary Artery Calcium (CAC) score test is a specialized, non-invasive computed tomography (CT) scan. It measures calcified plaque in the heart’s arteries, which is a marker of atherosclerosis (hardening of the arteries). The resulting numerical score directly assesses the atherosclerotic burden, helping to estimate an individual’s future risk of experiencing a heart attack or stroke. The test is a rapid, outpatient procedure that requires no injection of contrast dye, making it a valuable tool in preventative cardiology.
Criteria for Needing the Test
Ordering a Coronary Artery Calcium test is guided by a person’s overall risk for heart disease, especially when that risk is uncertain. Clinical guidelines suggest the test is most useful for asymptomatic adults, typically aged 40 to 75, who fall into an intermediate-risk category for atherosclerotic cardiovascular disease (ASCVD). This intermediate risk is often defined as a 10-year risk of 5% to just under 20% based on traditional risk calculators.
Appropriate candidates for the scan include people with specific risk-enhancing factors. These factors include a strong family history of premature heart disease, high cholesterol, hypertension, diabetes, or a history of tobacco use. The test is often recommended when a physician is unsure whether to begin preventive medication, such as a statin, as the calcium score can help upgrade or downgrade that risk assessment. The test is generally not recommended for those already diagnosed with coronary artery disease or those with a very low risk profile, since the results would not change their established treatment plan.
Scheduling the Scan
Ordering a Coronary Artery Calcium scan follows two pathways: referral or direct access. The traditional route requires a written prescription from a primary care physician or cardiologist. The patient then contacts an accredited hospital imaging department or an outpatient radiology center to schedule the appointment using this order.
Some specialized imaging centers offer the CAC scan as a self-referral or direct access screening package, often with flat-rate pricing. This allows an individual to bypass the initial doctor’s visit and order the scan directly, though a medical professional will still analyze the images and generate the report. To schedule, a patient should contact the facility’s central scheduling department and confirm they perform the non-contrast cardiac CT for calcium scoring.
The CAC scan typically takes only 10 to 15 minutes to complete and requires minimal preparation. Patients should avoid caffeine and smoking for several hours before the test, as these can increase the heart rate and interfere with image quality. During the procedure, electrodes are placed on the chest to monitor the heart’s rhythm, and the technician may ask the patient to briefly hold their breath to capture clear pictures.
Understanding the Costs
The financial aspect of the CAC test is crucial because it is often classified as a screening tool, not a diagnostic procedure. Consequently, it may not be covered by standard health insurance. Many insurance plans, including original Medicare, do not routinely cover the cost unless specific high-risk criteria are met and documented by the ordering physician.
If the test is not covered, patients are responsible for the full out-of-pocket cost, known as the self-pay rate. The cash price for a CAC scan is highly variable, generally ranging from $75 to $400, with an average cost often falling between $100 and $250. Pricing depends heavily on the geographic location and the type of facility; hospital systems often charge more than independent imaging clinics.
Before scheduling, patients should contact both the imaging center and the insurance provider to confirm pricing and coverage details. Specifically, ask the facility for their self-pay or cash price, which is often lower than the rate billed to insurance for non-covered services. Confirming the full cost beforehand prevents unexpected bills and allows for an informed decision.
Interpreting Your Calcium Score
The results of the scan are presented as an Agatston score, a numerical value quantifying the extent of calcified plaque. This score is derived by combining the area and density of all calcium deposits detected in the coronary arteries. A score of zero indicates no detectable calcification and suggests a very low risk of a heart event in the near future.
Scores between 1 and 10 are considered minimal calcification, while scores from 11 to 100 represent mild plaque buildup. This range suggests a low to mild increase in risk and often favors a discussion about preventive measures like statin therapy, especially for individuals over 55 years old.
A score between 101 and 400 signifies moderate calcification, which is associated with an increased risk of heart disease. This level may warrant more aggressive lifestyle modifications and medication. Scores exceeding 400 indicate extensive calcification and a high cardiovascular risk, suggesting a disease burden comparable to someone who has already experienced a cardiac event. The score is a predictor of future risk, not a diagnosis of an immediate heart attack, and the results must be reviewed with a physician to determine the appropriate subsequent steps.