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Medicare pays for a diagnostic mammogram when a doctor orders one, and for screening mammograms on a set schedule: none under 35, one between 35 and 39, and then one every year (at least 11 months apart) from age 40.
United States, Medicare National Coverage Determination 220.4, version 1; the NCD lists 15 May 1978 as its effective date and its benefit categories as diagnostic tests and screening mammography. It defines a diagnostic mammogram as one for a man or woman with signs or symptoms of breast disease, a personal history of breast cancer or of biopsy-proven benign breast disease, and a screening mammogram as one for a woman without signs or symptoms, "at a minimum a two-view exposure (cranio-caudal and a medial lateral oblique view) of each breast".
Screening frequency, in the NCD's words: "Payment may not be made for a screening mammography performed on a woman under age 35. Payment may be made for only one screening mammography performed on a woman over age 34, but under age 40. For an asymptomatic woman over age 39, payment may be made for a screening mammography performed after at least 11 months have passed following the month in which the last screening mammography was performed." A diagnostic mammogram is covered when ordered by a doctor of medicine or osteopathy, for signs and symptoms, a history of breast cancer, or an asymptomatic patient whose physician judges it appropriate.
Showing the technology this term belongs to: Mammography & tomosynthesis.
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