Medicare coverage for biomechanical computed tomography gives CT-based osteoporosis assessment a national reimbursement pathway under the Bone Mass Measurement benefit.
O.N. Diagnostics said implementation begins October 5, 2026, with coverage retroactive to January 1, 2024. The company also said beneficiary cost-sharing is waived for eligible Medicare patients because the service is covered as a Bone Mass Measurement test.
BCT is billed using CPT codes 0555T-0558T. CMS billing guidance lists those codes in its Bone Mass Measurement article, alongside other bone-density and bone-quality assessment codes.
CMS states that Bone Mass Measurement identifies bone mass, detects bone loss, or determines bone quality. The benefit includes physician interpretation and applies when coverage criteria are met.
O.N. Diagnostics’ VirtuOst BCT uses CT scans that include the hip or spine. The company said the test provides CT-based measurements of bone mineral density and bone strength.
The analysis can be applied to CT exams obtained for other clinical indications, according to O.N. Diagnostics. The company said most CT scans covering the hip or spine can be used without a calibration phantom or special imaging protocol.
Typical workflow separates the test into scan retrieval and transmission, BCT assessment, and physician interpretation. O.N. Diagnostics said code 0558T can be used when a CT scan is ordered solely for accompanying BCT.
The company’s reimbursement page states that BCT and BCT with concurrent vertebral fracture assessment are reimbursed by Medicare when considered reasonable and necessary. Private insurance coverage, including Medicare Advantage, depends on the patient’s plan.
CMS article history shows codes 0554T-0558T were added to a Bone Mass Measurement billing article with an effective date of July 1, 2019. The current update concerns Medicare coverage implementation, not creation of new CPT codes.
Company:O.N. Diagnostics
Sources
- Medicare covers biomechanical CT for osteoporosis. Government document
- NCD - Bone (Mineral) Density Studies (150.3). Government document
About the author
RadiologySignal.com writersEditorial Team
Radiology Signal Staff covers developments across medical imaging, radiology AI, imaging informatics, clinical research, and radiology business. The team monitors primary sources, peer-reviewed studies, company announcements, society updates, and healthcare industry news to deliver concise reporting for imaging professionals.
