Medicare Coverage for Lung Cancer Screening Frequently Asked Questions

Under the updated policy, Medicare provides coverage for annual LDCT lung cancer screening among Medicare beneficiaries who fit the following criteria:

• Age 50-77 years
• No current signs or symptoms of lung cancer
• Smoking history of at least 20 pack-years (pack-years are calculated by multiplying the number of packs smoked per day by number of years smoked)
• Currently smoke or have quit within the last 15 years

• Before a healthcare provider can provide an order for lung cancer screening to Medicare, they must have a shared decision-making discussion with the Medicare patient. This visit includes: 
• Confirming that the patient meets the high-risk criteria
• Discussing the benefits and risks of screening
• Providing information regarding follow-up after the scan
• Discussing the risks of over-diagnosis, radiation exposure, and false positives
• Counseling on the importance of being screened each year and the impact of other possible causes of death with lung cancer
• Counseling on the importance of quitting smoking, or staying quit, including information on Medicare-covered cessation services

Previously, LDCTs were only covered for Medicare patients aged 55-77 with a 30 pack-year smoking history, and who currently smoked or quit within the last 15 years. 

Based on an updated review of the latest evidence on lung cancer screening, Medicare approved expansion of the eligibility criteria. The minimum age was lowered from 55 to 50, and the required smoking history was reduced from 30 to 20 pack-years. This change allows more patients at high risk for lung cancer to have access to this lifesaving screening.

Eligible lung cancer screening sites must:

• Meet required technical specifications for screening protocol, radiation exposure, and low-dose CT equipment.
• Use a standardized data reporting system for lung nodule identification, classification and management 
• Use the American College of Radiology’s Lung Cancer Screening Locator Tool or connect with a Lung Health Navigator by visiting Lung.org/LCS-Assistance to find a screening site near you.

The expanded coverage began on Feb. 10, 2022.

Many private health insurance plans cover lung cancer screening without cost-sharing, but eligibility criteria vary based on type of plan you have. Many plans are currently updating their criteria to match new guidelines. Check out our coverage chart to learn more.