A bone density test, most commonly performed as a Dual-energy X-ray Absorptiometry (DXA or DEXA) scan, is a non-invasive imaging procedure that uses low-dose X-rays to measure bone mineral density (BMD). The primary goal of this test is to assess the strength of your bones and determine your risk for developing osteoporosis, a condition characterized by fragile, weakened bones. The DXA scan typically measures mineral content in the hip and spine, helping healthcare providers detect bone loss early so that appropriate treatment measures can be started.
Locating Testing Facilities
The search for a bone density test begins with identifying facilities that offer the specialized equipment required for a central DXA scan. This method is the most accurate and is typically performed in a hospital’s radiology or imaging department. These locations are equipped with the large, stationary machines needed to scan the hip and lower spine, which are the most reliable sites for assessing fracture risk.
Dedicated diagnostic imaging centers are another widely available option and often specialize in these procedures, sometimes offering more flexible scheduling than a large hospital. Specialized medical practices, such as orthopedic or endocrinology clinics, may also house DXA scanners on-site. To find a local facility, consult your primary care physician for a referral to a trusted imaging provider in your area.
You can also use your health insurance provider’s online search tool to filter for in-network diagnostic facilities that perform DXA scans. While some health fairs or pharmacies may offer peripheral DXA scans using small, portable devices on the wrist or heel, these are primarily screening tools. If a peripheral scan indicates a problem, a follow-up central DXA scan will be necessary for a definitive diagnosis and treatment planning.
Eligibility and Recommended Screening Ages
Medical organizations have established clear guidelines for who should undergo a bone density test, based primarily on age and specific risk factors. Routine screening is recommended for all women aged 65 and older, and for men aged 70 and older, as bone density naturally decreases with age. Screening may be necessary much earlier if certain medical or lifestyle factors are present.
Women who are postmenopausal but under 65 should consider a test if they have a family history of osteoporosis, low body weight, or other risk factors. Screening at a younger age is also recommended for individuals with a history of fragility fractures—a broken bone resulting from a fall from standing height or less. Certain medical conditions, such as hyperparathyroidism or rheumatoid arthritis, can accelerate bone loss and necessitate early testing.
Long-term use of specific medications, including high-dose corticosteroids like prednisone, can significantly reduce bone density and indicate a need for screening. Individuals who have experienced a substantial loss of height (an inch and a half or more) should also discuss testing with their healthcare provider. A physician will weigh these factors to determine the appropriate timing for a DXA scan.
Preparing for and Undergoing the Test
Preparation for a bone density test is minimal but important for accurate results. Patients must avoid taking any calcium supplements, including multivitamins containing calcium, for at least 24 hours before their appointment. This restriction prevents the supplements from interfering with the mineral density measurement.
On the day of the scan, wear loose, comfortable clothing free of metal, such as zippers, belts, and large buttons, as these items can block the X-ray beam. You will be asked to remove jewelry, eyeglasses, or any metal objects near the area being scanned. The procedure is quick, non-invasive, and painless, typically taking only 10 to 30 minutes to complete.
For the central DXA scan, you will lie on your back on a padded table while a mechanical arm passes over your lower spine and one hip. The machine emits a very low dose of radiation, significantly less than a standard chest X-ray, making the procedure safe. The technologist may use a positioning device to ensure your body is correctly aligned for the clearest images.
Financial Considerations and Coverage
Understanding the financial aspects of a bone density test is important, as insurance coverage is often tied to medical necessity and eligibility criteria. Medicare Part B covers a bone density test once every 24 months for beneficiaries who meet specific risk criteria. These criteria include being a woman with estrogen deficiency at clinical risk for osteoporosis, having an X-ray that shows signs of vertebral fractures, or being on certain steroid-type medications.
If you have Original Medicare and meet the eligibility requirements, the test is covered at 100% with no out-of-pocket cost, provided the facility accepts Medicare assignment. Individuals with Medicare Advantage plans will have the same level of coverage, but they should confirm the chosen facility is in-network to avoid unexpected expenses. For those who do not qualify for a fully covered screening, or who have commercial insurance, out-of-pocket costs can involve copayments or deductibles.
The actual cost of the procedure can vary based on the location where the test is performed. Outpatient diagnostic imaging centers often have lower facility fees than scans conducted within a hospital system. Before scheduling, contact both your insurance provider and the testing facility to confirm coverage details and any potential patient responsibility.