Does Medicare Cover Colonoscopies? 2026 Costs and Frequency
Reviewed October 5, 2026. Yes, Medicare covers colonoscopies. Part B pays for a screening colonoscopy once every 120 months (10 years) if you’re at average risk, or once every 24 months if you’re at high risk for colorectal cancer, and you pay nothing for the screening itself when your provider accepts assignment. If a polyp is removed during the screening, you pay 15% coinsurance in 2026, and the Part B deductible doesn’t apply.
Quick answer: Screening colonoscopies are a free preventive service under Original Medicare, with no minimum age. A follow-up colonoscopy after a positive stool-based or blood-based screening test is also treated as a screening, so it’s $0 too. A diagnostic colonoscopy, done because you have symptoms, is billed differently: you pay 20% after the $283 Part B deductible, plus any facility copayment.
How often does Medicare cover a colonoscopy?
Medicare.gov lists these frequency limits for a screening colonoscopy under Part B (Medicare.gov):
| Your situation | How often Medicare covers a screening colonoscopy |
|---|---|
| High risk for colorectal cancer | Once every 24 months |
| Not at high risk | Once every 120 months (10 years) |
| Not at high risk, after a flexible sigmoidoscopy | 48 months after the previous flexible sigmoidoscopy |
| Positive non-invasive stool test or blood-based biomarker test | A follow-up colonoscopy, covered as a screening |
There’s no minimum age for a Medicare screening colonoscopy. Your doctor decides whether you’re high risk based on factors such as a personal history of colorectal cancer or adenomatous polyps, inflammatory bowel disease (Crohn’s disease or ulcerative colitis), or a close relative who had colorectal cancer or polyps.
What does a colonoscopy cost with Medicare in 2026?
Your cost depends on why the colonoscopy is done and what happens during it.
| Type of colonoscopy | What you pay with Original Medicare (2026) |
|---|---|
| Screening colonoscopy, no polyps removed | $0 if your provider accepts assignment |
| Screening colonoscopy with polyp or tissue removal | 15% of the Medicare-approved amount for the doctor’s services, plus 15% coinsurance for the facility if done in a hospital outpatient department or ambulatory surgical center; the Part B deductible doesn’t apply |
| Follow-up colonoscopy after a positive stool-based or blood-based screening test | $0 if your provider accepts assignment |
| Diagnostic colonoscopy (you have symptoms such as bleeding or a change in bowel habits) | 20% of the Medicare-approved amount after the $283 Part B deductible, plus a facility copayment in a hospital outpatient setting |
Sources: Medicare.gov colonoscopy coverage and CMS 2026 Parts A and B premiums and deductibles. More on the deductible: Medicare Part B deductible 2026.
Why polyp removal changes your bill
When a polyp is found and removed during a screening colonoscopy, the procedure becomes therapeutic. Under a law Congress passed in 2020, Medicare is phasing out that coinsurance over several years. For 2026, you pay 15%, as shown on Medicare.gov. The coinsurance is scheduled to fall further in later years, so check Medicare.gov for the current percentage before your procedure.
Anesthesia and pathology
When the colonoscopy is a covered screening, Medicare also covers anesthesia related to the screening without cost-sharing. If tissue is removed, the lab work and pathology may be billed separately, so ask your provider what to expect.
Other colorectal cancer screening tests Medicare covers
A colonoscopy isn’t the only option. Part B also covers these screening tests when your doctor orders them:
| Test | Who’s eligible | How often | Your cost |
|---|---|---|---|
| Multi-target stool DNA test (such as Cologuard) | Ages 45 to 85, no symptoms, average risk | Every 3 years | $0 with assignment |
| Blood-based biomarker test | Ages 45 to 85, no symptoms, average risk | Every 3 years | $0 with assignment |
| CT colonography | Age 45 and older | Every 24 months if high risk, every 60 months if not, or 48 months after a previous flexible sigmoidoscopy or colonoscopy | $0 with assignment |
| Fecal occult blood test | Age 45 and older | Every 12 months | $0 with assignment |
| Flexible sigmoidoscopy | Age 45 and older | Every 48 months, or 120 months after a previous screening colonoscopy if not high risk | $0 with assignment for the screening |
Sources: Medicare.gov pages for multi-target stool DNA tests, blood-based biomarker tests and CT colonography.
If a stool DNA test or blood-based test comes back positive, Medicare covers the follow-up colonoscopy as a screening, so you won’t owe the diagnostic 20% for that procedure when your provider accepts assignment.
Screening vs. diagnostic colonoscopy
This is the distinction that most often surprises people on Medicare:
- Screening colonoscopy: you have no symptoms, and the test is done to look for cancer or polyps early. It’s a preventive service with no cost to you, unless a polyp is removed.
- Diagnostic colonoscopy: you have symptoms, such as rectal bleeding, anemia, abdominal pain or a change in bowel habits, or your doctor is monitoring a known condition. Standard Part B cost-sharing applies.
Before your appointment, ask your doctor’s office how the procedure will be scheduled and billed. If they believe Medicare may not pay for part of the service, they may ask you to sign an Advance Beneficiary Notice (ABN).
Colonoscopy coverage with Medicare Advantage
Medicare Advantage (Part C) plans must cover the same preventive colorectal cancer screenings as Original Medicare, and in-network preventive screenings generally have no cost-sharing. Plan rules still matter:
- Network: an HMO usually requires an in-network gastroenterologist and facility. A PPO lets you go out of network for a higher cost. See Medicare Advantage HMO vs. PPO.
- Referrals and prior authorization: some plans require a referral to a specialist, and some require approval for diagnostic procedures.
- Polyp removal and diagnostic costs: plans set their own copays for therapeutic and diagnostic colonoscopies, listed in the Evidence of Coverage.
If you’re comparing plans for 2027 during Medicare Open Enrollment (October 15 to December 7), check the specialist and outpatient surgery copays side by side using our Medicare plan comparison worksheet.
Does Medigap help with colonoscopy costs?
A Medicare Supplement (Medigap) policy can pay the 15% polyp-removal coinsurance and the 20% coinsurance for diagnostic colonoscopies, depending on the plan letter. With Plan G, for example, you’d typically owe only the Part B deductible for a diagnostic procedure, and nothing for a screening with polyp removal, because that coinsurance isn’t subject to the deductible. Learn more in what Medigap plans cover.
How to get a colonoscopy covered by Medicare
- Talk to your primary care provider about your risk level and which screening test fits you. Your yearly wellness visit is a good time to review all your preventive services, including the vaccines Medicare covers.
- Confirm the provider and facility accept Medicare assignment (or are in your plan’s network).
- Ask how the procedure will be coded: screening, screening with possible polyp removal, or diagnostic.
- Check timing: make sure enough time has passed since your last colonoscopy or sigmoidoscopy.
- Review your Medicare Summary Notice after the procedure and compare it with any bill. If something looks wrong, call the provider’s billing office first, then appeal if needed.
Frequently asked questions
Does Medicare pay 100% for a colonoscopy?
Medicare pays 100% for a screening colonoscopy when your provider accepts assignment and no polyps or tissue are removed. If a polyp is removed, you pay 15% coinsurance in 2026. A diagnostic colonoscopy is subject to the 20% Part B coinsurance and the deductible.
Is there an age limit for Medicare colonoscopy coverage?
There’s no minimum age for a Medicare screening colonoscopy, and Medicare.gov doesn’t list an upper age limit for colonoscopy. Stool DNA and blood-based screening tests are covered for ages 45 to 85. Your doctor can help decide whether screening still makes sense for you.
How often will Medicare pay for a colonoscopy if polyps were found?
If your doctor considers you high risk, for example because of a history of adenomatous polyps, Medicare covers a screening colonoscopy once every 24 months.
Does Medicare cover Cologuard?
Yes. Medicare covers a multi-target stool DNA test like Cologuard once every 3 years for people ages 45 to 85 who have no symptoms and are at average risk. You pay nothing if your provider accepts assignment.
Does Medicare cover the colonoscopy prep kit?
The bowel prep is usually a prescription drug you pick up at the pharmacy, so it’s generally covered under your Medicare Part D or Medicare Advantage drug plan, not Part B. Your plan’s formulary and copays apply. See how Medicare Part D works.
Does Medicare cover a colonoscopy for someone with Crohn’s disease or colitis?
Yes. Inflammatory bowel disease is one of the factors that can make you high risk, which allows a screening colonoscopy every 24 months. Colonoscopies to monitor or treat the condition are billed as diagnostic.
This article is general information, not medical or individual insurance advice. Talk with your doctor about which screening is right for you. Medicare365 is not affiliated with or endorsed by the U.S. government or the federal Medicare program.