Getting a DEXA scan depends on whether you want one for medical bone density testing or for body composition analysis. For a medical bone density scan, you’ll typically need a doctor’s order and may qualify for insurance coverage. For a body composition scan, many clinics offer direct-to-consumer appointments with no referral needed, usually for an out-of-pocket fee. Here’s how to navigate both paths.
Medical vs. Body Composition Scans
DEXA (dual-energy X-ray absorptiometry) scans serve two distinct purposes, and the route to getting one differs for each. A medical DEXA scan measures bone mineral density to screen for osteoporosis or osteopenia. These are ordered by a physician, performed at hospitals or radiology centers, and often covered by insurance. A body composition DEXA scan measures your fat mass, lean mass, and bone density across different regions of your body. Fitness enthusiasts and people tracking weight loss use these to get precise body fat percentages. Body composition scans are almost always self-pay.
The machine and technology are identical. The difference is in what’s being measured, who orders it, and who pays for it.
Getting a Medical Bone Density Scan
If your goal is checking bone health, start with your primary care doctor or OB-GYN. They’ll evaluate your risk factors and, if appropriate, write an order for the scan. Most women age 65 or older should have a bone density scan as part of routine screening. Women under 65 and men of any age may also qualify if they have risk factors such as:
- Very low body weight
- One or more fractures after age 50
- Losing half an inch or more of height within a single year
- A family history of osteoporosis
- Long-term use of tobacco or alcohol
- Low calcium or vitamin D intake
- Conditions like diabetes or rheumatoid arthritis
- Current or planned use of steroid medications like prednisone
Once your doctor writes the order, their office will typically schedule you at a nearby imaging center or hospital radiology department. Some primary care and endocrinology offices have DEXA machines on-site, which makes the process even simpler.
Insurance Coverage and Medicare
Most private insurance plans cover bone density scans when a doctor determines they’re medically necessary, though your copay or deductible will vary by plan. Call your insurer before scheduling to confirm coverage and find out which imaging centers are in-network.
Medicare Part B covers bone mass measurements once every 24 months if you meet at least one of these conditions: you’re a woman determined to be estrogen-deficient and at risk for osteoporosis, your X-rays suggest osteoporosis or vertebral fractures, you’re taking or about to start steroid-type drugs, you’ve been diagnosed with primary hyperparathyroidism, or you’re being monitored to see if osteoporosis treatment is working. More frequent scans may be covered if your doctor documents medical necessity.
If you’re paying out of pocket for a medical bone density scan, expect to spend roughly $160 to $175, though prices vary by location and facility.
Getting a Body Composition Scan
Body composition DEXA scans don’t require a doctor’s referral. A growing number of wellness clinics, sports medicine facilities, and specialized body scanning studios offer walk-in or online booking. Search for “DEXA body composition scan” plus your city to find local options. Chains like DexaFit operate in many metro areas, and university-affiliated sports science labs sometimes offer scans to the public as well.
These scans typically cost between $75 and $150 per session, with some clinics offering discounted packages if you plan to scan every few months to track progress. Insurance does not cover body composition scans since they’re considered elective.
How to Prepare
DEXA scans require minimal preparation, but a few details matter. If you take calcium supplements or other over-the-counter vitamins, stop taking them 24 hours before your test. Calcium in your system can interfere with the accuracy of bone density readings. Wear loose, comfortable clothing without metal zippers, buttons, or belt buckles. You’ll likely be asked to remove jewelry. If you’ve had a barium study or been injected with contrast dye for a CT scan recently, let the scheduling office know, as residual contrast can affect results.
For body composition scans, consistency matters if you’re comparing results over time. Try to scan at the same time of day, with the same hydration level, and ideally on a similar schedule relative to meals and exercise. Many clinics recommend scanning in the morning before eating or working out.
What Happens During the Scan
The scan itself is quick and painless. You lie flat on a padded table while a scanning arm passes over your body. There’s no enclosed tube like an MRI, and the radiation exposure is extremely low, roughly one-tenth the dose of a standard chest X-ray. The whole process takes about 10 to 20 minutes, and you can get dressed and leave immediately afterward. Results are usually available within a few days for medical scans, or sometimes on the spot for body composition appointments.
Understanding Your Results
For bone density scans, results come as a T-score, which compares your bone density to that of a healthy 30-year-old. A T-score of negative 1 or higher means your bones are healthy. A score between negative 1 and negative 2.5 indicates osteopenia, a milder form of bone loss that warrants monitoring and possibly lifestyle changes. A score of negative 2.5 or lower suggests osteoporosis, which your doctor will want to address with treatment.
If you’re younger than 50 or premenopausal, your report may use a Z-score instead, which compares your density to others of the same age and sex. A Z-score below negative 2.0 is considered below the expected range and prompts further investigation into underlying causes.
For body composition scans, you’ll get a detailed breakdown of fat mass, lean tissue, and bone mineral content for your whole body and individual regions like arms, legs, and trunk. The report will include your total body fat percentage, visceral fat estimates, and sometimes a comparison to population norms for your age and sex. These numbers give you a far more accurate picture than a bathroom scale or BMI calculation, which is why athletes and people managing body composition changes find them useful for tracking progress over time.