Osteoporosis screening outreach for practices

Primary care, family medicine, internal medicine and gynecology practices see the women who are due for osteoporosis screening long before they ever visit a bone density clinic. The USPSTF puts the prevalence of osteoporosis at 27.1 percent among women 65 years or older in the United States, and screening is the step that finds it before a fracture does. The outreach side is where practices get it wrong: a reminder sent to a patient who had a scan last year, a flyer that tells all Medicare patients the scan is free, or a list pull that leaves out women under 65 who qualify. This guide covers who the federal sources say to screen, how the Medicare benefit and its frequency rule work, how to build a recall list, and how to word reminders and pages.

This guide is about finding and reminding the patients who are due. How a bone density clinic presents the scan, heel scans, treatment claims and supplements on the shelf are covered in our guide to osteoporosis clinic marketing and are not repeated here. Medicare wellness visits are in our guide to annual wellness visit outreach, fall risk programs in our guide to falls prevention program outreach, and screening at community events in our guide to health fair screening event marketing.

This is general information, not legal, billing or medical advice. Sources cited were checked on October 30, 2026: the USPSTF recommendation Osteoporosis to Prevent Fractures: Screening (final statement dated January 14, 2025) and the USPSTF list of recommendations in progress, 42 CFR 410.31 and the Medicare.gov page on bone mass measurements, 42 CFR 410.15, 45 CFR 147.130, 47 CFR 64.1200, 16 CFR 255.2 and 15 U.S.C. 45. Coverage and payment rules change, Medicaid rules differ by state and plan coverage differs by plan; check yours with your billing team and a health care attorney.

What the USPSTF recommends

The U.S. Preventive Services Task Force final recommendation on screening for osteoporosis to prevent fractures is dated January 14, 2025. It gives a B grade to screening for osteoporosis in women 65 years or older, and a B grade to screening in postmenopausal women younger than 65 who are at increased risk for an osteoporotic fracture as estimated by clinical risk assessment. For men, it issues an I statement: the evidence is insufficient to assess the balance of benefits and harms. The Task Force says the I statement is not a recommendation against screening, and that clinicians should use their clinical judgment about screening men.

For women under 65, the Task Force suggests two steps. The clinician first looks for risk factors, which it lists as including low body weight, parental history of hip fracture, cigarette smoking and excess alcohol consumption. For women with one or more risk factors, the clinician then uses a clinical risk assessment tool to decide whether screening is warranted. Screening means DXA bone mineral density, with or without fracture risk assessment. The recommendation does not apply to people who already have osteoporosis, a history of fragility fracture, or conditions or medications associated with bone loss. On the date we checked, the USPSTF list of recommendations in progress did not include this topic.

Say women 65 and older are recommended for screening, and that younger postmenopausal women may be due based on their risk, as the clinician decides.
Do not tell men they need a scan, and do not tell them they do not. Say the clinician will talk with them about whether screening makes sense.
Leave the risk tool and the scan type to the clinician. Outreach copy should not name a tool or score.

When to screen again

Patients and staff ask when the next scan is due. The USPSTF does not set an interval. It says the evidence on screening intervals is limited, notes cohort studies suggesting that repeating bone density testing at 4 to 8 years did not add accuracy in predicting fractures, and reports that the time to reach osteoporosis was shorter for women with lower starting scores and older age. That makes the interval a clinical decision for each patient, not a marketing message.

Use: “Your clinician will tell you when your next bone density test is due.”
Avoid: “Get your bone scan every year” or “every two years for all women.” Neither matches the USPSTF statement.

The Medicare bone mass measurement benefit

Medicare Part B coverage is set out in 42 CFR 410.31. The test must be ordered by the physician or qualified nonphysician practitioner treating the beneficiary after an evaluation of the need for it, performed under the right level of supervision, and include a physician’s interpretation. The regulation lists five groups who may be covered: a woman the treating clinician determines to be estrogen-deficient and at clinical risk for osteoporosis based on her medical history and other findings; a person with vertebral abnormalities on an x-ray indicating osteoporosis, osteopenia or vertebral fracture; a person receiving or expecting to receive long-term glucocorticoid (steroid) therapy above the level the rule sets for more than 3 months; a person with primary hyperparathyroidism; and a person being monitored for response to an FDA-approved osteoporosis drug therapy.

The Medicare.gov page describes the benefit as once every 24 months, or sooner if medically necessary, and says the patient pays nothing if the provider accepts assignment. Note that Medicare eligibility is not the same as the USPSTF wording. Medicare does not cover a scan because a patient turned 65. The woman must meet one of the listed conditions, as the treating clinician determines, and the order must come from that clinician.

Use: “Medicare Part B covers bone density tests for people who meet certain conditions. Ask us whether you qualify.”
Avoid: “Free bone scan for every woman on Medicare” or “Medicare pays for a scan when you turn 65.” Coverage depends on the listed conditions, an order from the treating clinician and assignment.
Have the billing lead confirm codes, diagnosis requirements and frequency before any page or letter mentions Medicare.

The 23-month rule and recall timing

The frequency standard in 42 CFR 410.31(c)(1) is more exact than the 24 months on Medicare.gov. Medicare may cover a bone mass measurement if at least 23 months have passed since the month the last one was performed. The regulation allows testing at shorter intervals when medically necessary, and gives monitoring of long-term glucocorticoid therapy of more than 3 months and a confirmatory baseline DXA as examples. A reminder that goes out before the window opens can lead to a scan the patient is billed for, which is the outcome outreach should prevent.

Store the month and year of the last bone density test in the chart where the recall query can read it.
Ask new patients where and when their last scan was done, and request the report, since a scan at another facility still counts toward the frequency rule.
Build the recall so a Medicare patient is not reminded until the 23-month window has opened, unless the clinician has ordered an earlier test.
Have the clinician, not the recall list, decide the interval for patients who are not on Medicare.

Coverage outside Medicare

Under 45 CFR 147.130, non-grandfathered group health plans and health insurance issuers must cover, without cost-sharing, items and services that have in effect an A or B rating in the current USPSTF recommendations. Both osteoporosis screening recommendations for women are rated B. The regulation has exceptions and timing rules, plan details differ, and Medicaid coverage is set by each state. A page can say screening is a recommended preventive service for women who meet the criteria. It should not promise that a patient will pay nothing.

Use: “Bone density screening is a preventive service the USPSTF recommends for women who meet its criteria. Our front desk can check what your plan covers.”
Avoid: “No cost to you,” “covered by all insurance” or “free with any plan.”

Building the recall list

A recall list is a query against the practice’s own records, run by the care team for treatment purposes. The list should follow the clinical recommendation, with the clinician’s sign-off on the criteria.

Women 65 and older with no bone density test on file, or with a last test old enough that the clinician wants it repeated.
Postmenopausal women under 65 whom the clinician has flagged as at increased risk after a risk assessment. Do not pull this group by age alone.
Patients the clinician has flagged for monitoring, such as those on long-term steroid therapy, handled as clinical follow-up rather than a screening reminder.
Leave out patients already in treatment for osteoporosis or with a fragility fracture history unless the clinician wants them on a monitoring list; the screening recommendation does not apply to them.
Men only when the clinician has decided to screen, since the Task Force found the evidence insufficient.

Bringing screening into the wellness visit

The simplest place to raise screening is a visit the patient already has. Under 42 CFR 410.15, the Medicare annual wellness visit includes a written screening schedule, such as a checklist for the next 5 to 10 years, based on USPSTF and ACIP recommendations and the patient’s health risk assessment, and the schedule is updated at later wellness visits. A practice that puts bone density on that schedule gives the patient a dated plan, which reads better than a stand-alone ad. Our guide to annual wellness visit outreach covers how to promote the visit itself.

Reminders for screening

Under 47 CFR 64.1200(a)(9)(iv), calls and texts to wireless numbers made by or on behalf of healthcare providers are exempt from prior express consent only when all of its conditions are met. They go only to the wireless number the patient provided, state the provider’s name and contact details, and are strictly limited to listed purposes, which include appointment and exam confirmations and reminders, wellness checkups and lab results. They contain no telemarketing, solicitation or advertising and no billing or other financial content, comply with HIPAA privacy rules, stay concise (generally 160 characters or fewer for a text), are limited to one message a day and three a week, and offer an easy opt out. Our guide to text message appointment reminders covers the wider setup.

Use: “[Practice name]: you are due for a screening test your clinician recommended. Call [phone] or book in the portal. Reply STOP to opt out.”
Avoid: “Free bone scan this month!” or any promotional wording in a reminder sent under the healthcare exemption.
Do not put osteoporosis, a T score or a test result in a text. Keep details for the visit or the portal.

Pages that inform patients

Search data shows patients asking practical questions: what age to start, whether men need it, whether Medicare covers it and when to repeat it. A short screening page that answers those questions in plain words, reviewed by a clinician and linked to the sources, serves them better than a banner offer.

Explain what the test is: a low-dose x-ray scan of bone density, ordered by the clinician.
Say who the USPSTF recommendation covers and link it, with its date.
Say how Medicare coverage works in the words of 42 CFR 410.31 and Medicare.gov, without promising zero cost.
Say what happens after a result: the clinician explains it and talks through next steps. Link the clinic guide or the specialist the practice refers to.
Keep condition pages free of ad tracking pixels unless your attorney has reviewed the setup. Our guide to tracking pixels on practice websites covers tracking on health pages.

Claims to leave out

“Prevent fractures” as a promise to one patient. The USPSTF found a moderate net benefit for screening, which describes results across groups, not a promise for one person.
“Reverse bone loss” or “cure osteoporosis” in screening copy. Treatment belongs with the clinician; our osteoporosis clinic marketing guide covers treatment claims.
“Free bone scan for seniors” or any free offer built around Medicare.
Named drugs, devices or supplements in screening outreach.
Fear wording aimed at one patient, such as “your bones could break at any moment.” Use the USPSTF prevalence figures as group statistics, with the source.
A patient’s fracture story used as an ad. Under 16 CFR 255.2(b), an ad that presents one consumer’s result is likely to be read as what others will generally achieve, unless that is substantiated or what people can generally expect is clearly disclosed, and claims must be truthful and substantiated under 15 U.S.C. 45.

Illustration: two recall campaigns

This is an invented example to show the difference, not a real practice. Campaign A texts all women on Medicare: “Free bone density scan for seniors this month, protect yourself from fractures!” It reaches a patient scanned 14 months earlier and leaves out a 58-year-old the clinician had flagged as at risk. Campaign B pulls women 65 and older with no scan in the chart, adds the younger women the clinician flagged, holds Medicare patients until 23 months have passed since the month of their last scan, and sends a plain reminder that names the practice and offers an opt out. Campaign A breaks the reminder rules and the frequency rule. Campaign B follows the sources.

Checklist before the recall goes out

The criteria match the USPSTF 2025 statement, and a clinician signed off on them.
Medicare wording matches 42 CFR 410.31: the listed conditions, an order from the treating clinician, and the frequency rule.
The last scan date, including scans done elsewhere, is in the chart and read by the recall query.
Coverage wording does not promise zero cost; Medicaid details come from your own state’s current rules.
Reminders meet the conditions in 47 CFR 64.1200(a)(9)(iv) and carry no promotion, diagnosis or results.
No page promises to prevent fractures or reverse bone loss, and no patient story is used as an ad without review.
A clinician, the billing lead and a health care attorney approved the list criteria, the pages and the messages.

How we help

We build websites, local search, Google Ads, patient lead generation and AI front desk tools for independent practices and health businesses, including primary care, internal medicine and gynecology practices. For osteoporosis screening, that means a site that explains screening in plain words, condition pages with no ad tags, copy checked against the current USPSTF and Medicare sources before it goes live, and reminders that stay within the healthcare exemption. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it.

Who does the USPSTF recommend screening for osteoporosis?

The final statement dated January 14, 2025 gives a B grade to screening women 65 years or older, and to screening postmenopausal women younger than 65 who are at increased risk for an osteoporotic fracture as estimated by clinical risk assessment. For men the evidence is insufficient (an I statement).

Should men be screened for osteoporosis?

The USPSTF found the evidence insufficient to weigh benefits and harms for men, and says that is not a recommendation against screening. Clinicians use their judgment, and the recommendation does not apply to people with conditions or medications associated with bone loss.

Does Medicare cover a bone density test?

Yes, for people who meet one of the conditions in 42 CFR 410.31, with an order from the treating clinician. Medicare.gov says the patient pays nothing if the provider accepts assignment.

When can a Medicare patient have another bone density test?

Under 42 CFR 410.31(c), Medicare may cover a test once at least 23 months have passed since the month of the last one, or sooner when medically necessary, such as monitoring long-term steroid therapy.

When should women repeat a bone density scan?

The USPSTF does not set an interval and says the evidence is limited. The clinician decides for each patient, and the Medicare frequency rule applies to Medicare patients.

Can we text patients about a bone density test?

Yes, as a reminder within the conditions of 47 CFR 64.1200(a)(9)(iv): only to the number the patient gave, no promotion, no billing content, concise, within the message limits and with an opt out. Keep the diagnosis and results out of the text.

Osteoporosis screening outreach: the USPSTF 2025 recommendation, the Medicare bone mass measurement benefit, recall lists and reminders