Low-dose CT lung cancer screening: USPSTF ages and criteria

When it starts, when it can stop

Starts: At 50, for people with a 20 pack-year history who smoke now or quit within the past 15 years. (USPSTF, 2021)
Can stop: At 80, or once a person has not smoked for 15 years, or if a health problem substantially limits life expectancy or the ability or willingness to have lung surgery. (USPSTF, 2021)

Who it is for

Adults aged 50 to 80 years with a 20 pack-year smoking history who smoke now or quit within the past 15 years. (USPSTF, 2021)

Work out your pack-years: pack-year calculator.

In My Screening Plan this shows up when you tick: 20 or more pack-years, and I smoke now or quit in the last 15 years.

Test and how often

A low-dose CT scan (LDCT) every year. (USPSTF, 2021)
Stop once you have not smoked for 15 years, or if a health problem substantially limits life expectancy or the ability or willingness to have lung surgery. (USPSTF, 2021)
One pack-year means smoking an average of 20 cigarettes (1 pack) a day for a year. So 20 pack-years is, for example, 1 pack a day for 20 years or 2 packs a day for 10 years. (USPSTF, 2021)

Who pays: Medicare and private insurance

Lung cancer screening: USPSTF ages versus Medicare coverage
	USPSTF (2021) and most private plans	Medicare Part B (since February 10, 2022)
Ages	50 to 80	50 to 77
Smoking history	20 pack-years; smoke now or quit within 15 years	20 pack-years; smoke now or quit within 15 years
How often	Once a year	Once a year
Before the first scan	No set requirement	A counseling and shared decision-making visit, and an order from your provider

HealthCare.gov lists lung cancer screening for adults 50 to 80 at high risk because they are heavy smokers or quit in the past 15 years among the preventive services Marketplace plans and many other plans must cover without a copayment or coinsurance. (HealthCare.gov)

Medicare Part B covers a yearly low-dose CT for people 50 to 77 with no signs or symptoms of lung cancer, a 20 pack-year history, who smoke now or quit within the last 15 years, with an order from a provider. Before the first scan you need a visit to discuss the benefits and risks. You pay nothing if your provider accepts assignment. (Medicare.gov) (CMS NCD 210.14)

So the ages differ: at 78 to 80 the USPSTF still recommends the scan, but Medicare Part B does not cover it. Ask your doctor and your plan before you book. (USPSTF, 2021) (CMS NCD 210.14)

Questions people ask

Does Medicare cover lung cancer screening?

Yes, once a year, if you are 50 to 77, have no symptoms, have a 20 pack-year history, smoke now or quit within the last 15 years, and have an order from your provider. You pay nothing if your provider accepts assignment. (Medicare.gov)

Why does Medicare stop at 77 when the USPSTF says 80?

They are separate decisions. The USPSTF recommendation (2021) covers 50 to 80; the Medicare national coverage determination (NCD 210.14, effective February 10, 2022) sets 50 to 77 for Part B coverage. (USPSTF, 2021) (CMS NCD 210.14)

Is a low-dose CT scan covered by private insurance?

HealthCare.gov lists lung cancer screening for adults 50 to 80 at high risk among the preventive services that Marketplace plans and many other plans must cover without a copayment or coinsurance. Check with your plan which providers are in network. (HealthCare.gov)

Do I need a separate visit before the first scan?

With Medicare, yes: a counseling and shared decision-making visit before the first scan. It checks that you qualify, uses one or more decision aids, covers why yearly scans and your other health conditions matter, and covers quitting or staying off cigarettes. (CMS NCD 210.14)

What helps if I want to quit smoking?

The USPSTF recommends counseling plus FDA-approved medicines for adults who smoke, and there is a free quitline, 1-800-QUIT-NOW. Details and sources are on our quit smoking page. Read more: quitting smoking. (USPSTF, 2021)

Source

U.S. Preventive Services Task Force, "Lung Cancer: Screening", final recommendation released March 9, 2021. Read it on uspreventiveservicestaskforce.org. Checked against the live page on 2026-10-27.

Lung cancer screening with low-dose CT