Quick Answer
Yes, Medicare Part B covers echocardiograms when a doctor orders them as medically necessary. Echocardiograms are not a routine preventive service under Medicare, so your doctor must document a clinical reason for the test. Once you meet your $283 Part B deductible, you pay 20% of the Medicare-approved amount. A Medigap plan can cover that 20%, leaving you with little or no out-of-pocket cost.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Medicare Part B (Outpatient) | Covered | Covers 80% after $283 Part B deductible; you pay 20% coinsurance |
| Medicare Part A (Inpatient) | Covered | Covered when performed during a qualifying hospital inpatient stay |
| Medicare Advantage (Part C) | Covered | Must cover same services as Original Medicare; cost-sharing varies by plan |
| Medicare Supplement (Medigap) | Varies by Plan | Covers some or all of the 20% coinsurance left by Part B |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Covered when medically necessaryOriginal Medicare covers echocardiograms when a physician orders the test because it is medically necessary — for example, to investigate chest pain, diagnose heart disease, or monitor a known cardiac condition. Echocardiograms are not included in the annual wellness visit and are not a preventive screening benefit.
**Medicare Part B** covers outpatient echocardiograms performed at a doctor's office, outpatient hospital department, or cardiac imaging center. After you meet the annual Part B deductible ($283 in 2026), Medicare pays 80% of the Medicare-approved amount and you pay the remaining 20%. If you are a hospital inpatient and receive an echocardiogram during that stay, **Medicare Part A** applies instead.
Medicare also covers one screening **EKG (electrocardiogram)** in your lifetime — but only when ordered as part of your Welcome to Medicare preventive visit within the first 12 months of enrollment. Any additional EKGs must be medically necessary to receive Part B coverage.
What It Covers
- Transthoracic echocardiogram (TTE) — most common type
- Transesophageal echocardiogram (TEE) — used when TTE images are insufficient
- Stress echocardiogram — performed during or after exercise or medication-induced stress
- Diagnostic EKGs ordered for a medical reason
- One-time screening EKG during Welcome to Medicare visit
- Holter monitors and cardiac event monitors (when medically necessary)
- Other heart tests: stress tests, chest X-rays, cardiac CT scans, coronary angiography
What It Doesn't Cover
- Routine echocardiograms without a documented medical reason
- Echocardiograms ordered by a provider who does not accept Medicare
- Repeated EKGs without medical necessity documentation
Part B: You pay 20% coinsurance after the $283 annual deductible (2026). The average cost of an EKG is approximately $205; Medicare pays 80% after your deductible.
Medicare Advantage (Part C)
Covered — cost-sharing varies by planMedicare Advantage plans are required to cover all services that Original Medicare covers, including medically necessary echocardiograms and EKGs. However, the cost-sharing structure — deductibles, copayments, and coinsurance — is set by the private insurer and may differ from Original Medicare.
Unlike Medicare Supplement plans, Medicare Advantage plans use provider networks. Before scheduling your echocardiogram, confirm that your cardiologist and the imaging facility are both in your plan's network. Out-of-network services may result in higher costs or may not be covered at all, depending on your plan type (HMO vs. PPO).
What It Covers
- All echocardiogram types covered by Original Medicare
- EKGs and other cardiac diagnostic tests
- Cardiac monitoring devices (Holter monitors, event monitors)
What It Doesn't Cover
- Out-of-network providers (for HMO plans without out-of-network benefits)
- Tests not deemed medically necessary by your plan's criteria
Verify Network Status before Your Appointment
Call your Medicare Advantage plan before scheduling your echocardiogram. Confirm the cardiologist, the imaging facility, and any interpreting physicians are all in-network to avoid unexpected bills.
Medicare Supplement (Medigap)
Covers some or all of Original Medicare's cost-sharingMedicare Supplement (Medigap) plans pay the out-of-pocket costs that Original Medicare leaves behind. Because Medicare Part B covers echocardiograms, a Medigap plan can cover the 20% coinsurance — and in some cases the Part B deductible as well — significantly reducing what you owe.
With Medigap Plan G, for example, you pay only the $283 annual Part B deductible (2026). After that, Plan G covers the 20% coinsurance for all Medicare-approved services, including echocardiograms, EKGs, and other cardiac tests. Medigap plans have no provider networks, so any cardiologist who accepts Medicare will also accept your Medigap plan.
What It Covers
- Part B coinsurance (20%) — covered by most Medigap plans
- Part A deductible — covered by Plans D, G, and others
- Part B deductible — covered by Plan C and Plan F (for those eligible before Jan 1, 2020)
- Excess charges — covered by Plans F and G
With Medigap Plan G, your only out-of-pocket cost for an echocardiogram is the $283 Part B deductible per year (2026). After that, Plan G covers the 20% coinsurance.
Echocardiogram vs. EKG: Key Differences
| Feature | Echocardiogram | EKG (Electrocardiogram) |
|---|---|---|
| How it works | Uses sound waves (ultrasound) to create images of the heart's structure and function | Uses electrodes placed on the chest to record the heart's electrical activity |
| Test duration | 20–45 minutes on average | 5–10 minutes on average |
| What it shows | Heart chamber size, pumping function, valve health, blood flow patterns | Heart rate, rhythm, electrical conduction, signs of prior heart attack |
| Common diagnoses | Heart failure, valve disease, cardiomyopathy, pericarditis, congenital defects | Arrhythmias, atrial fibrillation, heart block, ischemia |
| Medicare coverage | Part B covers unlimited tests when medically necessary | One free screening at Welcome to Medicare visit; unlimited diagnostic EKGs when medically necessary |
| Typical Medicare cost (2026) | 20% coinsurance after $283 Part B deductible | 20% coinsurance after $283 Part B deductible (for diagnostic EKGs) |
✦ When Medicare Covers a Routine EKG
One-Time Screening EKG at Your Welcome to Medicare Visit
Medicare Part B covers one screening EKG in your lifetime — but only when it is ordered as part of your Initial Preventive Physical Examination (IPPE), also known as the 'Welcome to Medicare' visit. You must attend this visit within the first 12 months of enrolling in Part B.
If you miss the Welcome to Medicare window, you will not receive a free routine EKG. Any future EKG must be medically necessary to receive Medicare coverage.
Unlimited Diagnostic EKGs When Medically Necessary
Outside of the one-time screening benefit, Medicare Part B covers unlimited EKGs as long as your physician documents a medical reason for each test. Common reasons include chest pain, shortness of breath, suspected arrhythmia, pre-operative evaluation, or monitoring of a known heart condition.
Other Heart Tests Medicare Covers
In addition to echocardiograms and EKGs, Medicare Part B covers a range of cardiac diagnostic tests when medically necessary. If your doctor determines any of the following tests are needed to diagnose or monitor a heart condition, Medicare will cover its share of the cost.
Cardiac Tests Covered by Medicare Part B
- Holter monitor (24–48 hour continuous heart rhythm recording)
- Cardiac event monitor (worn for weeks to capture intermittent arrhythmias)
- Stress test (exercise or pharmacologic)
- Stress echocardiogram
- Chest X-ray
- Cardiac CT scan
- Coronary angiography (cardiac catheterization)
- Nuclear cardiac imaging (myocardial perfusion imaging)
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.