The standard osteoporosis screening test is a central DEXA (also written DXA) scan, a quick, painless X-ray of your hip and spine that measures bone mineral density. The U.S. Preventive Services Task Force recommends it for all women 65 and older and for postmenopausal women under 65 who are at increased risk. For men, the evidence is thinner, so the decision is one to make with your clinician.
This guide covers who should be screened and when, what the test involves, how to read the result, what Medicare pays for, and why home tests do not count.
TL;DR
- A central DEXA scan of the hip and spine is the preferred test for screening and diagnosing osteoporosis. Heel, wrist and finger scans only screen.
- Screen all women at 65 and older, and postmenopausal women under 65 with added risk factors. For men, the Task Force found insufficient evidence for routine screening, so talk to your clinician.
- A T-score of -2.5 or lower suggests osteoporosis, but your fracture history and risk factors matter as much as the number.
- Medicare Part B covers a bone mass measurement every 24 months for qualified beneficiaries. Cash scans are an option for everyone else.
Table of Contents
- What an osteoporosis screening test actually measures
- When to screen for osteoporosis
- DEXA versus other screening tests
- What to expect at the scan
- Reading your result
- What to do after an abnormal result
- How often to repeat the test
- Does insurance cover an osteoporosis screening test?
- Our perspective: the number is only half the story
- Find a DEXA clinic near you
- Preparing for your appointment
- FAQ
- Sources
What an osteoporosis screening test actually measures
Osteoporosis is a "silent" disease. The FDA notes that you typically have no symptoms and may not know you have it until you break a bone. That is the whole case for screening: finding weak bone before the fracture, not after.
A bone mineral density test measures calcium and other minerals in bone. Denser bones tend to be stronger and less likely to break. The test compares your density with a reference value and gives you a score.
The Bone Health and Osteoporosis Foundation says a bone mineral density test is the only one that can diagnose osteoporosis, and that central DEXA is the preferred method. In practice, "osteoporosis screening test" and "DEXA scan" mean the same thing for most people.
When to screen for osteoporosis
The answer depends on your sex, age and risk profile.
Women 65 and older
As of January 2025, the USPSTF recommends screening for osteoporosis to prevent fractures in women aged 65 and older. This is the clearest rule in the field. If you are 65 or older and have never had a scan, that is your cue to schedule one.
Postmenopausal women under 65
The same recommendation covers postmenopausal women younger than 65 who are at increased risk, as determined by clinical risk assessment. Your clinician weighs factors such as a parent's hip fracture, current smoking and heavy drinking. The Bone Health and Osteoporosis Foundation lists those factors along with excessive alcohol use, meaning two to three or more drinks a day.
Men
The Task Force found insufficient evidence to recommend for or against routine screening in men. That does not mean men never need a scan. It means the decision is individual. A man with a prior fracture, long-term steroid use or other risk factors should raise the question with his doctor.
Anyone with warning signs
Because the disease is silent, the signs are indirect. The Foundation points to these as reasons to talk with a provider:
- Height loss of 1.5 inches or more
- Noticeable changes in posture
- Persistent back pain
- A broken bone after age 50
For a wider look at how bone density changes across a lifetime, see our guide to bone density by age. For the guideline detail, see bone density test guidelines.
DEXA versus other screening tests
Not every bone test is equal. This is where people get misled.
| Test type | What it measures | Can it diagnose osteoporosis? |
|---|---|---|
| Central DEXA (hip and spine) | Bone mineral density at the sites where fractures matter most | Yes |
| Peripheral scan (heel, wrist, finger) | Density at an outlying bone | No, screening only |
| Home or DIY kit | Varies, not validated for site-specific diagnosis | No |
The Foundation's guidance is that peripheral scans cannot diagnose osteoporosis. If one suggests bone loss, a central DEXA of the hip or spine is the necessary next step. The same source advises avoiding home bone density tests, because they do not provide the validated, site-specific data needed to manage bone health.
So if a pharmacy screening, health fair or heel scanner flags a concern, treat it as a prompt, not a result. Book a central scan.
What to expect at the scan
A central DEXA is short and uncomplicated. You lie on a padded table while an arm passes over you and takes low-dose X-ray images of the hip and lower spine. You stay clothed, though you will likely be asked to remove metal such as belt buckles. Our DEXA scan procedure guide walks through the visit, which takes roughly 10 to 20 minutes.
Radiation is the question most people ask. The Foundation describes the dose from a central DEXA as extremely low, typically far less than the natural background radiation you absorb on a round-trip flight between New York and San Francisco. That is why repeat testing is considered reasonable when it is medically indicated.
Reading your result
Your report centers on the T-score, which compares your density with that of a healthy young adult. According to the USPSTF:
| T-score | Category |
|---|---|
| -1 or higher | Normal |
| Between -1 and -2.5 | Osteopenia (low bone mass) |
| -2.5 or lower | Suggests osteoporosis |
What the number does not tell you is your actual fracture risk. The Foundation stresses that the T-score is critical but does not tell the whole story. Someone with a "normal" score can still need treatment if a prior fracture or medication use puts them at high risk. Someone with osteopenia may need nothing more than monitoring.
That is why clinicians increasingly pair DEXA with a risk calculator called FRAX, which estimates your 10-year probability of a major osteoporotic fracture. If your report lands in the osteopenia range, our FRAX walkthrough shows how the calculation works. A plain-language FRAX score explainer also covers how risk estimates connect to treatment decisions for adults 50 and older.
For line-by-line help with your report, use our guide to reading DEXA results. To understand the gap between the two diagnoses, read osteopenia versus osteoporosis.
What to do after an abnormal result
A low T-score is a starting point for a conversation with your primary care clinician, an endocrinologist or a rheumatologist. Treatment is individualized: medication, calcium and vitamin D intake, fall prevention and exercise can all play a role, depending on your risk.
Some people also look for supervised, resistance-style programs aimed at bone health. If you are exploring that route, ask your clinician first, and look at what in-person options exist locally, such as osteogenic loading sessions offered at centers in the Sacramento area. These are not a substitute for a diagnosis or for medical treatment of osteoporosis.
How often to repeat the test
Bone changes slowly, so there is no value in scanning every few months. Medicare's schedule gives a useful benchmark: a covered bone mass measurement once every 24 months. More frequent testing may be covered when medically necessary, for example to monitor long-term steroid therapy or to check how well an FDA-approved osteoporosis drug is working.
Two habits make follow-up scans far more useful:
- Ask for the same machine. Calibration can vary slightly between densitometers, even within one building. Visiting the same facility is not enough. Request the exact same machine when you book.
- Keep your reports. Bring the earlier scan so the comparison is like for like.
Our DEXA timing guide explains why bone scans are spaced two or more years apart, while body composition scans follow a much shorter rhythm.
Does insurance cover an osteoporosis screening test?
For Medicare beneficiaries, often yes. Medicare Part B covers bone mass measurements, including DEXA, once every 24 months for qualified people. Examples include women whom a provider has determined to be estrogen-deficient and at risk, and people with vertebral abnormalities or long-term steroid use. You pay nothing if your provider accepts assignment.
The details are specific. Medicare's coverage determination spells out the medical necessity conditions a bone mass measurement must meet, and your physician's documentation matters. If you are unsure whether you qualify, call your plan or the clinic before booking. Our guide to avoiding surprise DEXA bills covers the questions to ask.
If you are not covered, are younger than the guideline age and curious, or simply do not want to chase a referral, a cash-pay scan is a practical route. Cash prices vary by clinic, so compare before you book.
Our perspective: the number is only half the story
We built Dexascans because the hardest part of getting a DEXA scan is rarely the scan. It is finding a place that does one, learning the price, and working out whether you need a physician's order. Many people who should be screened never are, because the path looks like a maze of referrals and surprise bills.
Our view is simple. First, a central DEXA is the test to book, and anything that cannot diagnose should be followed by one. Second, ask what you will do with the answer. A scan is most useful when you bring the report to a clinician who weighs it against your history, not when you treat a T-score as a verdict. Third, price transparency is a health issue: people skip care they cannot price.
That is why every location on our platform is verified, with source-backed cash prices and the scan types offered listed up front, so you can compare clinics and book directly. We would rather you scan once, correctly, on a machine you can return to, than scan twice because the first result was not usable.
— Erik
Find a DEXA clinic near you
Dexascans lists more than 511 verified locations across 48 states where you can book a bone density or body composition scan without a referral. Search by city or ZIP on our DEXA scan locations page, compare cash prices, and book with the clinic directly. For costs, T-score context and what to look for in a provider, start with our bone density test page.
If your goal is body fat and lean mass rather than bone, the body composition scan page covers that, and many clinics offer combined appointments.
Preparing for your appointment
A few practical steps help the visit go smoothly:
- Wear comfortable clothing without metal zippers, snaps or underwire.
- Tell the technologist about recent contrast imaging or nuclear medicine tests, and whether you could be pregnant.
- Mention fractures, spinal surgery or implants. They can affect which sites are measured.
- Bring your list of medications, especially steroids and any osteoporosis drugs.
- Confirm the machine. For a follow-up, ask to be scanned on the same one as last time.
After the scan, request a copy of the report and images. You will want them for your next comparison.
FAQ
At what age should I screen for osteoporosis?
The USPSTF recommends screening women at 65 and older. Postmenopausal women under 65 should be screened if a clinical risk assessment shows increased risk. For men, the evidence is insufficient for routine screening, so ask your clinician based on your own risk factors.
Will insurance cover a bone density test?
Medicare Part B covers a bone mass measurement once every 24 months for qualified beneficiaries, with no cost to you if the provider accepts assignment. Private plans vary, so confirm coverage and whether you need an order before you book. A cash-pay scan avoids the referral step.
Can I check my bone density at home?
Not in a way that counts. The Bone Health and Osteoporosis Foundation advises against home or DIY bone density tests because they lack validated, site-specific data. A central DEXA at a clinic is the test that can diagnose osteoporosis.
What are the warning signs of osteoporosis?
Often there are none until a fracture. Height loss of 1.5 inches or more, posture changes, persistent back pain and a bone broken after age 50 are reasons to talk with a provider. Risk factors include a parent's hip fracture, smoking and heavy drinking.
Sources
- USPSTF: Osteoporosis to Prevent Fractures: Screening
- Bone Health and Osteoporosis Foundation: Boning Up brochure
- FDA: Osteoporosis
- NIAMS: Bone Mineral Density Tests, What the Numbers Mean
- Medicare.gov: Bone mass measurements
- CMS: LCD Bone Mass Measurement (L39268)