View 2020 copay rates for VA and VA-approved health care.
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Keep in mind that your co-pay will depend on the purpose of the scan and where it’s performed. For example, one that’s ordered by an emergency room doctor because of a life-threatening condition will most likely be more expensive, and the co-pay will be higher.
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Doctor’s ofice visit, a $25 copay for the X-ray, and either a $15 copay or 50 percent coinsurance (whichever is greater) for the generic drug. Your copays (except for prescriptions) contribute toward your. MRI, MRA, CT Scan $125 PET and combined PET/CT $225 Interventional Radiology and Diagnostic Radiology Services only performed in a hospital outpatient setting (procedures done under anesthesia that are image-based) $250 Dialysis $0 No coinsurance 100% of allowable charges No maximum benefit No other information. Physical Therapy (after discharge.
Effective January 1, 2020
Note: Some Veterans don't have to pay copays (they're 'exempt') due to their disability rating, income level, or special eligibility factors.
Urgent care copay rates
(Care for minor illnesses and injuries)
There's no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, you must:
- Be enrolled in the VA health care system, and
- Have received care from us within the past 24 months (2 years)
You won’t have to pay any copay for a visit where you’re only getting a flu shot, no matter your priority group.
| Priority group | Copay amount for first 3 visits in each calendar year | Copay amount for each additional visit in the same year | |||
|---|---|---|---|---|---|
| Priority group | 1 to 5 | Copay amount for first 3 visits in each calendar year | $0 (no copay) | Copay amount for each additional visit in the same year | $30 |
| Priority group | 6 | Copay amount for first 3 visits in each calendar year | If related to a condition that's covered by a special authority*: $0 (no copay) If not related to a condition covered by a special authority*: $30 each visit | Copay amount for each additional visit in the same year | $30 |
| Priority group | 7 to 8 | Copay amount for first 3 visits in each calendar year | $30 | Copay amount for each additional visit in the same year | $30 |
* Special authorities include conditions related to combat service and exposures (like Agent Orange, active duty at Camp Lejeune, ionizing radiation, Project Shipboard Hazard and Defense (SHAD/Project 112), Southwest Asia Conditions) as well as military sexual trauma, and presumptions applicable to certain Veterans with psychosis and other mental illness.
Outpatient care copay rates
(Primary or specialty care that doesn't require an overnight stay)
If you have a service-connected disability rating of 10% or higher
You won't need to pay a copay for outpatient care.
If you don't have a service-connected disability rating of 10% or higher
You may need to pay a copay for outpatient care for conditions not related to your military service, at the rates listed below.
| Type of outpatient care | Copay amount for each visit or test | ||
|---|---|---|---|
| Type of outpatient care | Primary care services (like a visit to your primary care doctor) | Copay amount for each visit or test | $15 |
| Type of outpatient care | Specialty care services (like a visit to a hearing specialist, eye doctor, surgeon, or cardiologist) | Copay amount for each visit or test | $50 |
| Type of outpatient care | Specialty tests (like an MRI or CT scan) | Copay amount for each visit or test | $50 |
Note: You won’t need to pay any copays for X-rays, lab tests, or preventive tests and services like health screenings or immunizations.
Inpatient care copay rates
(Care that requires you to stay one or more days in a hospital)
If you have a service-connected disability rating of 10% or higher
You won't need to pay a copay for inpatient care.
If you’re in priority group 7 or 8
You'll pay either our full copay rate or reduced copay rate. If you live in a high-cost area, you may qualify for a reduced inpatient copay rate no matter what priority group you're in. To find out if you qualify for a reduced inpatient copay rate, call us toll-free at 877-222-8387. We're here Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.
| Length of stay | Copay amount | ||
|---|---|---|---|
| Length of stay | First 90 days of care during a 365-day period | Copay amount | $281.60 copay + $2 charge per day |
| Length of stay | Each additional 90 days of care during a 365-day period | Copay amount | $140.80 copay + $2 charge per day |
Note: You may be in priority group 7 and qualify for these rates if you don't meet eligibility requirements for priority groups 1 through 6, but you have a gross household income below our income limits for where you live and you agree to pay copays.
| Length of stay | Copay amount | ||
|---|---|---|---|
| Length of stay | First 90 days of care during a 365-day period | Copay amount | $1,408 copay + $10 charge per day |
| Length of stay | Each additional 90 days of care during a 365-day period | Copay amount | $704 copay + $10 charge per day |
Note: You may be in priority group 8 and qualify for these rates if you don't meet eligibility requirements for priority groups 1 through 6, and you have a gross household income above our income limits for where you live, agree to pay copays, and meet other specific enrollment and service-connected eligibility criteria.
Medication copay rates
If you’re in priority group 1
You won’t pay a copay for any medications.
Note: You may be in priority group 1 if we've rated your service-connected disability at 50% or more disabling, if we've determined that you can't work because of your service-connected disability (called unemployable), or if you've received the Medal of Honor.
If you’re in priority groups 2 through 8
You'll pay a copay for:
- Medications your health care provider prescribes to treat non-service-connected conditions, and
- Over-the-counter medications (like aspirin, cough syrup, or vitamins) that you get from a VA pharmacy. You may want to consider buying your over-the-counter medications on your own.
Note: The cost for any medications you receive while staying in a VA or other approved hospital or health facility are covered by your inpatient care copay.
The amount you’ll pay for these medications will depend on the “tier” of the medication and the amount of medication you’re getting, which we determine by days of supply. Once you’ve paid $700 in medication copays within a calendar year (January 1 to December 31), you won’t have to pay any more that year—even if you still get more medications. This is called a copay cap.
| Outpatient medication tier | 1-30 day supply | 31-60 day supply | 61-90 day supply | ||||
|---|---|---|---|---|---|---|---|
| Outpatient medication tier | Tier 1 (preferred generic prescription medicines) | 1-30 day supply | $5 | 31-60 day supply | $10 | 61-90 day supply | $15 |
| Outpatient medication tier | Tier 2 (non-preferred generic prescription medicines and some over-the-counter medicines) | 1-30 day supply | $8 | 31-60 day supply | $16 | 61-90 day supply | $24 |
| Outpatient medication tier | Tier 3 (brand-name prescription medicines) | 1-30 day supply | $11 | 31-60 day supply | $22 | 61-90 day supply | $33 |
If you have a service-connected rating of 40% or less and your income falls at or below the national income limits for receiving free medications, you may want to provide your income information to us to determine if you qualify for free medications.
Geriatric and extended care copay rates
You won't need to pay a copay for geriatric care (also called elder care) or extended care (also called long-term care) for the first 21 days of care in a 12-month period. Starting on the 22nd day of care, we'll base your copays on 2 factors:
- The level of care you're receiving, and
- The financial information you provide on your Application for Extended Care Services (VA Form 10-10EC).
| Level of care | Types of care included | Copay amount for each day of care | |||
|---|---|---|---|---|---|
| Level of care | Inpatient care | Types of care included |
| Copay amount for each day of care | Up to $97 |
| Level of care | Outpatient care | Types of care included |
| Copay amount for each day of care | Up to $15 |
| Level of care | Domiciliary care for homeless Veterans | Types of care included |
| Copay amount for each day of care | Up to $5 |
Services that don't require a copay
You won't need to pay a copay for any of the services listed below, no matter what your disability rating is or what priority group you're in.
- Laboratory (lab) tests
- Electrocardiograms (EKGs or ECGs) to check for heart disease or other heart problems
- VA health initiatives that are open to the public (like health fairs)
Other information you may need
Pay your copay bill
Find out how to pay your copay bill—and what to do if you disagree with the charges or are having trouble making payments.
Your health care costs
Learn how we assess and verify your income to help determine if you're eligible for VA health care and whether you'll need to pay copays for certain types of care, tests, and medications.
Copayments for maternity care (PDF)
We cover maternity care for eligible Veterans through arrangements with community providers. Download this fact sheet to find out more about copays.
Welcome to CompareCatScanCosts.com where you can:
- Determine what a CAT Scan should cost
- Learn how cost reimbursement for a CAT Scan works
- Learn money saving tips when getting a CAT Scan
- Learn about CT (computed tomography) procedures
What is a CAT Scan or CT Scan?
A CAT scan (also called a CT scan) is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. CAT scans allow physicians to rapidly create detailed pictures of the body allowing them to more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders. CAT scans may also be used to guide surgeons to the right area during a biopsy. CAT scans are one of the more common imaging technologies used by physicians to analyze the internal structures of various parts of the body. There are approximately 52 million CAT scan test performed each year making this one of the more common imaging technologies used by the medical field.
What Does A CAT Scan Cost?
Not all hospitals and imaging centers charge the same amount for CAT scans. You have a choice of where you get your CT scan performed and you will most likely save a significant amount of money. By doing a little homework and shopping around you can save hundreds and possibly thousands of dollars. CAT scan procedure costs can range between $270 and $4,800. Costs are broken down into two areas:
Technical Fees: this is the cost of the CAT scan procedure itself and where there is a potential to save a considerable amount of money.
Professional Fees: : this is the fee associated with having the radiologist interpret the test result.
When you contact a testing facility make sure you identify the complete cost of the CAT scan because often all the additional fees and technical fees can add up and cause for a rather large bill.
Why do CAT scan cost vary so much?
CAT scan cost vary based upon the type of CAT scan you're getting (abdominal versus brain for example) as well as where you have the procedure performed. Similar to the price of a new automobile. Everyone knows that the 'sticker price' is just an asking price. There's a nice mark-up included in that price and often if you ask the dealer to come off that price they will. Medical procedures are often no different. Most hospitals and imaging centers have a 'sticker price' which are often on the high end. If you ask and work with most facilities they will often offer a substantial discount to individuals and insurance carriers due to the form of payment and the volume of procedures they pay for on an annual basis. There's more on this below so keep reading.
CAT Scan Costs Averages
As noted above, CAT Scan costs can vary by thousands of dollars and it's important that you shop around for your procedure. For example, listed below are some real examples or CAT Scan prices from around the United States.
| Testing Facility Location | Test Type | Average Cost |
|---|---|---|
| Houston, TX | Cat Scan | $3,016 |
| Chicago, IL | Cat Scan | $2,237 |
| Atlanta, GA - Testing Facility A | Cat Scan | $698 |
| Atlanta, GA - Testing Facility B | Cat Scan | $2,214 |
| Phoenix, AZ | Cat Scan | $2,199 |
| Omaha, NE | Cat Scan | $1,611 |
| Portland, OR - Testing Facility A | Cat Scan | $1,520 |
| Portland, OR - Testing Facility B | Cat Scan | $678 |
| Cleveland, OH | Cat Scan | $1,075 |
Take Atlanta, GA for example. Facility A charges $698 for a CAT scan while Facility B charges $2,214. That's a $1,516 difference! There's nothing different about the procedure being done but there sure is a difference between he cost of Facility A and Facility B. Take the testing facilities in Portland, OR. It's very similar to the two CT scan facilities in Atlanta. Facility A charges $1,520 for the CT scan while Facility B only cost $678. Again, a huge difference in price. Amazingly these price discrepancies exist all over the United States. So, make sure you shop for your procedures and save money!
Cancellation Policies
New Choice Health - Medical Cost Comparison
Save Up to 40% on a CAT Scan!
Find and compare CAT Scan prices at local medical facilities with NewChoiceHealth
www.NewChoiceHealth.com
Most hospitals and imaging centers do not charge for appointments which are cancelled within 24 hours of the scheduled appointment or procedure. If you do cancel the procedure within 24 hours most facilities will charge you a cancellation fee of $100 to $750. These cost/fees are associated with lost income opportunity of having the CT scan machine in use during the scheduled appointment. If the machine is not being used for a procedure then it is just costing the imaging facility or hospital money. Therefore make sure that you do not cancel within 24 hours of appointment or just no-show because you will most likely be charged a cancellation fee which is not reimbursable by your insurance company.
Payment Methods
In addition to accepting typical medical insurance reimbursement, most all hospitals and imaging centers accept the following payment methods; cash, check, MasterCard, Visa, Discover, and American Express credit cards. Most all testing facilities require any out-of-pocket deductible or co-payment be paid upon office visit. For uninsured customers, most testing facilities offer 15% - 40% discount when the full discounted amount is paid by cash or credit within 60 days of the procedure.
Costs Reimbursement - Insured Customers
Most insurance companies, including Medicare, will reimburse the cost of getting a CT scan. In most situations when a CT scan is requested by a medical professional the procedure is automatically determined to be reimbursable dependant upon your particular insurance plan. It's important that you are familiar with your insurance prior to having any procedure, especially expensive procedures, performed to know if there are any special notifications or authorizations that need to be secured to ensure reimbursement. Make sure you notify the imaging doctor or technician of your concerns or pre-certification prior to any elective tests or procedures. If pre-certification is required by our insurance carrier and you do not get such pre-certification this may result in full denial of your insurance claim. Medicare and other insurance coverage policies are always changing so it is important that you contact Medicare (www.mericare.gov) or your insurance company to determine coverage prior to having any procedure performed.
Costs Reimbursement - Uninsured Customers
If you do not have insurance you may qualify for a 15% - $40% discount if the discounted balance of the procedure cost is paid in full within 60 days of the procedure. Most facilities accept cash, cashiers checks, and Visa, MasterCard, and American Express credit cards. Depending on your financial status and specific situation, a greater discount or charity may apply. In addition there may be other alternatives to working with the imaging centers for payment and/or procedure cost reimbursement.
Costs Reimbursement - Other Alternatives & Options
If your financial situation presents a challenge for making full payment for a CAT scan procedure make sure you ask for assistance. Be honest and up front about your situation and work with the hospital or imaging center to determine the various alternatives to reducing the cost of the CAT scan or spreading out the cost to make it easier to manage with your current cash flow. Some possible payment options include:
Payment Plans: Hospitals and imaging centers often do not accept payment plans, but exceptions are often made in extreme financial hardship cases. So if the cost of a CAT scan puts you in a financially vulnerable position do not hesitate to ask for some type of payment plan.
Charity Care Qualifications: If your family income and assets are within 200% of Federal Poverty Guidelines, financial assistance may be provided. Imaging centers and hospitals often consider these on a case-by-case basis. If you meet the initial screening criteria the facility may need to review your federal income tax returns, current pay stubs, and/or denial of third party benefits.
Employees Group Benefit Program: If you are a participating employee in a Group Benefit Program at work, you and your employer can arrange to have the cost of your CAT scan paid for under the program by your employer's group insurance carrier on an 'extra-contractual' basis. The terms vary from plan to plan, but group benefit programs invariably provide for such 'extra-contractual' arrangements. The expense is tax-deductible to the employer so make sure you speak with your employer before you pay for your CAT scan.
Tax Credits : If you do end up having to pay for the cost of a CAT scan you may be eligible for a medical tax credit. Make sure you keep your paperwork and receipt and speak with an accountant. This may be very helpful for people who are retired and may save you hundreds of dollars in taxes.
CAT Scan Costs Rule of Thumb
Kaiser Ct Scan Cost Copay
- There are lots of CAT scan imaging facilities in each market and usually they all have much different prices. So, do your research and shop for the best price, you may save up to a thousand dollars!
- Hospital imaging facilities are usually priced higher than freestanding imaging centers.
- If you are uninsured or participate in a Health Savings Account make sure that you ask for the best possible CT scan rate. A facilities 'best price' is often much less than a facility's published 'price.'
How does a CAT Scan work?
New Choice Health - Medical Cost Comparison
Save Up to 40% on a CAT Scan!
Find and compare CAT Scan prices at local medical facilities with NewChoiceHealth
www.NewChoiceHealth.com
Copay For Ct Scan
CAT scans use special x-ray equipment to produce multiple pictures of the inside of the body. Software joins the pictures together in cross-sectional views for detailed examination. CAT scans can be used to view internal organs, bone, soft tissue and blood vessels. These scans provide greater clarity than conventional x-ray exams. Often a special dye, called contrast, may be ingested to further enhance the scan images and the various structural relationships of the areas of interest. so that specific areas inside the body are highlighted. CT scans are often used to defining the structural relationships of the spin, the spinal cord, and its nerves. CT scans are also used in the chest to identify tumors, cysts, or infections that may be suspected on a chest x-ray. CT scans of the abdomen are extremely helpful in defining body organ anatomy, including visualizing the liver, gallbladder, pancreas, spleen, aorta, kidneys, uterus, and ovaries. CT scans in this area are used to verify the presence or absence of tumors, infection, abnormal anatomy, or changes of the body from trauma.
The information contained on this page is for information purposes only and should not be taken as medical advice. Please consult your physician on any medical conditions, diagnostic testing, or any general medical issue.