A bone density test, known as DEXA or DXA, is a specialized, low-dose X-ray procedure that measures the mineral content and strength of your bones. This non-invasive test primarily focuses on the hip and lower spine, the areas most susceptible to fragility fractures. Its main purpose is to screen for and diagnose osteoporosis, a condition characterized by low bone mass that increases the risk of breaks. The result of the scan, often presented as a T-score, helps healthcare providers assess your current bone health and fracture risk.
Starting with a Healthcare Provider
Getting a bone density test requires a referral from a healthcare professional. A referral is typically required for most insurance carriers to cover the cost. Primary Care Physicians (PCPs) are often the first point of contact. Specialists like Gynecologists, Endocrinologists, and Rheumatologists can also order the test, especially if you have known risk factors.
Your provider will determine the need for a DEXA scan based on established guidelines and your personal health profile. Routine screening is recommended for all women aged 65 and older and men aged 70 and older. Testing is also advised for younger individuals who have significant risk factors, such as a history of fragility fractures, specific medical conditions, or long-term use of certain medications like glucocorticoids (steroids).
The provider’s role is to order the correct diagnostic code to ensure the test is covered and to interpret the results for you. They will use the DEXA scan results, often alongside a fracture risk assessment tool like FRAX, to create a comprehensive picture of your bone health. This initial step secures the necessary paperwork and medical justification, but the physical scan itself is performed at a dedicated imaging site.
Locating Specialized Testing Facilities
Once you have a referral, the next step is finding a facility equipped to perform the DEXA scan. DEXA technology is the current standard for measuring central bone mineral density. The most common and reliable locations for obtaining a DEXA scan are within hospital systems.
Hospital radiology departments typically house the necessary DEXA scanners and provide a high level of technical expertise and oversight from radiologists. Alternatively, many people choose to visit Outpatient Imaging Centers, which are standalone facilities focused solely on diagnostic imaging. These centers often offer greater scheduling flexibility and can sometimes provide faster appointment times than a large hospital setting.
For individuals in rural or underserved areas, mobile testing units occasionally travel to community centers or clinics to offer convenient screenings. When scheduling, you should specifically confirm that the location performs bone densitometry using DEXA technology. Some sites may only offer peripheral scans of the wrist or heel, which are not considered the standard for diagnosing osteoporosis. Making sure the facility accepts your physician’s referral and is in-network with your insurance is a necessary check before your appointment.
Navigating Insurance and Costs
Coverage is often dependent on specific medical criteria. Most private insurance plans and Medicare Part B cover the DEXA scan if you meet certain age or risk factor guidelines. For instance, Medicare covers the test once every 24 months for eligible individuals, including women 65 and older, and those with specific risk factors like hyperparathyroidism or long-term steroid use.
Before scheduling, contacting your insurance provider is strongly recommended to confirm coverage and determine any potential out-of-pocket expenses. Even with coverage, you may still be responsible for a deductible, co-pay, or co-insurance, which for Medicare Part B is typically 20% of the approved amount. Some testing facilities or physician offices may assist with this process by seeking pre-authorization from your insurer to avoid unexpected costs.
If you do not meet the criteria for insurance coverage, or if you have a high deductible plan, you may consider asking the imaging center about self-pay rates. Without insurance, the cost of a DEXA scan can vary widely, but some facilities offer negotiated cash prices that are substantially lower than the billed amount.