Utah · Medicare · PSA tests, the age question and what a high result costs

Does Medicare Cover PSA Tests in Utah? (2026 Costs)

Yes. Medicare Part B pays for a PSA blood test every 12 months for every man over 50, with no deductible, no coinsurance and no age at which it stops; the yearly rectal exam is covered too, at 20%. What can cost money is what a high result sets in motion: the urology visit, the MRI, the biopsy and, for the Utah men who go on to treatment, the surgery or radiation. Here is the whole picture for a Utah retiree: the rules, what each step actually cost Utah men in CMS's own 2024 claims file, why Utah has more prostate cancer than the nation and a higher death rate from it, which Utah towns have a urologist, how the Task Force's “talk first” advice fits with Medicare's “we pay,” and how a Medigap policy or a Medicare Advantage plan handles each bill.

Utah Retirement Income Data Desk

Reviewed by Brian Penner, Retirement income & long-term care planner · Published October 8, 2026

Prostate cancer screening came into Medicare in the same law as the yearly mammogram: the Balanced Budget Act of 1997 added it to Part B effective January 1, 2000, as a screening digital rectal exam and a screening prostate-specific antigen (PSA) blood test, each once every 12 months for men who have reached 50. Medicare.gov's page today puts the costs plainly: for PSA blood tests, “you pay nothing for the PSA blood test,” and for the rectal exam, “after you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the digital rectal exam and for your doctor's services related to the exam.” CMS's claims manual explains why the two are treated differently: the screening PSA “is a lab test to which neither deductible nor coinsurance apply,” while “both deductible (if unmet) and coinsurance are applicable to screening rectal examinations.” That is the first thing to understand about this benefit. The blood test is free of cost-sharing not because it is a screening but because it is a clinical laboratory test, and Original Medicare pays clinical lab tests in full; the exam is a physician service and is paid like one.

The second thing to understand is that the medicine is less settled than the billing. Medicare has paid for a yearly PSA from age 50 with no upper age limit since 2000, and CMS's claims system checks only age, sex and the 12-month interval. The U.S. Preventive Services Task Force, after a long argument over whether PSA screening saves more lives than it harms, settled in 2018 on “the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one” for men 55 to 69, after a conversation about the small benefit and the real harms (false positives, biopsies, overdiagnosis, and the incontinence and erectile dysfunction that can follow treatment), and “recommends against PSA-based screening for prostate cancer in men 70 years and older.” So a Utah man of 72 can have a Medicare-paid PSA every year for the rest of his life, and his doctor may well suggest he stop. Both are true. What makes this worth a Utah article is that Utah's numbers push in opposite directions: Utah men on Medicare get fewer PSA tests than the nation, Utah has more prostate cancer than the nation and its rate is rising, and Utah's death rate from it is higher, even though Utah finds a smaller share of its cases late. We take each in turn.

What does Medicare cover for prostate cancer screening, and how often?

The rules below are quoted from Medicare.gov, from the federal regulation (42 CFR 410.39) and from chapter 18, section 50 of CMS's Medicare Claims Processing Manual, the instruction CMS gives the contractors that pay the claims. “Assignment” means the provider accepts the Medicare-approved amount as payment in full. The screening tests must be ordered by, or the exam performed by, a doctor, physician assistant, nurse practitioner, clinical nurse specialist or certified nurse midwife who is “fully knowledgeable about the beneficiary” and will explain the result, so a walk-in lab order is not a screening PSA; your own clinician orders it.

Sources: Medicare.gov, Prostate cancer screenings; 42 CFR 410.39; CMS, Medicare Claims Processing Manual, chapter 18, section 50 (effective date, who may order, “neither deductible nor coinsurance apply” to the screening PSA, the exam's deductible and coinsurance, bundling of the exam into a same-day visit, the 11-month counting rule, code 0359U); CMS, 2026 Medicare Parts A & B Premiums and Deductibles — medicare.gov, ecfr.gov, cms.gov (PDF), cms.gov.

Two details matter in practice. First, the screening PSA has its own billing code and a screening diagnosis code, and your doctor's office chooses between “screening” and “diagnostic” when it orders the test; because both are lab tests with no cost-sharing, the choice does not change what you pay, which is nothing, but a test billed as screening counts against the 12-month limit and a diagnostic one does not. A man being watched for a rising PSA can have it checked every three months as a diagnostic test at $0. Second, the rectal exam is the one screening item with cost-sharing, and in Utah almost no one pays it separately: CMS's file shows only 11 Utah claims for a stand-alone screening rectal exam in 2024 (7,317 nationally), at $21.03 approved and $10.62 paid, which is what the deductible and 20% look like on a claim. The rest were done during an office visit and billed as part of it.

What do you pay for a PSA test with Medicare in 2026, and what does a high result cost?

Nothing for the test, and CMS's claims file proves it the same way it did for mammograms and colonoscopies: for the Utah screening PSA, the diagnostic PSA and the free PSA, the average amount Medicare paid in 2024 equals the average amount it approved, to the cent. There was no deductible and no 20% on any of 6,845 screening PSA tests or 9,534 diagnostic ones billed by Utah laboratories. The money starts with the result. A PSA above the level your doctor uses, or one that has risen quickly, usually brings a repeat test, then a visit with a urologist, then, increasingly, a prostate MRI before any needle, then a biopsy under ultrasound guidance in a urologist's office or a hospital outpatient department, then the pathologist's reading of each tissue core. Each of those is a Part B service at 20% after the $283 deductible, and because the screening PSA often rides along with the January wellness-visit bloodwork, the work-up is frequently the first Part B bill of the year and goes entirely to the deductible.

Sources: CMS, Medicare Physician & Other Practitioners by Geography and Service, 2024, Utah office and facility rows for G0103, 84153, 99204, 72197, 76872, 76942 and 55700; CMS, Medicare Outpatient Hospitals by Geography and Service, 2024, Utah APC 5373 line for 55700 — data.cms.gov (physicians), data.cms.gov (outpatient hospitals).

The biopsy is where the setting matters most. In 2024, 830 of the 996 Utah men whose biopsy was billed by a Utah urologist had it in an office, where Medicare approved a single $220.08 fee for the procedure plus the ultrasound and guidance fees; 166 had it in a facility setting, where the urologist's fee drops to $129.98 and the hospital bills its own facility fee, which averaged $1,672.81 across the 207 Utah hospital outpatient biopsies in CMS's hospital file ($1,918.47 nationally). The man in the office owed about $77; the man in the hospital about $367, for the same needle. Utah does more of its biopsies in offices than the nation does (83% of Utah's against 46% nationally), which is one reason the average Utah biopsy costs a Utah man less. Then comes the pathology: a standard biopsy takes twelve or more cores, and the pathologist's examination is billed per specimen at $56.44 (2024 Utah office average), so the lab bill for a biopsy can run from one specimen's fee to a dozen depending on how the cores are submitted, at 20% to you.

Averages across all Utah claims for each code in 2024, office (global) row unless noted; hospital facility amounts are the Utah average approved amount on the APC 5373 line for the biopsy and the Utah average Medicare payment for MS-DRG 708 for the surgery. Not price quotes. A non-participating provider may charge up to 15% above the approved amount on physician services (never on the lab test). Sources as above; CMS, Medicare Inpatient Hospitals by Geography and Service, 2024.

How many Utah men on Medicare get PSA tests, and how does Utah compare?

Fewer than elsewhere. CMS's file of Original Medicare claims counts 6,845 Utah beneficiaries with a screening PSA in 2024, 3.73% of everyone with Part B in Original Medicare, against 5.03% nationally, 0.74 times the national rate. Because the benefit is for men, the better denominator is men: applying the male share of Utah's Medicare population (47.0%) to Part B Original Medicare enrollment gives roughly 86,285 Utah men, of whom about 7.9% had a screening PSA in the year, against about 11.0% nationally. The screening code is only part of the story, because a great many PSA tests are billed as diagnostic, for an enlarged prostate, a prior result or simply because that is how the office orders them: Utah laboratories billed a diagnostic PSA for 9,534 Original Medicare beneficiaries in 2024, and adding the two codes puts the ceiling at about 19% of Utah men with any PSA in the year, against 28% nationally (a man can appear under both codes, and a lab test is attributed to the state of the laboratory, so the diagnostic figure is approximate). Either way, Utah tests less, and did in 2022 as well (3.10% vs. 4.63% on the screening code).

Distinct Original Medicare beneficiaries with each service billed by a Utah clinician (or, for a lab test, a Utah laboratory) in 2024, facility and office rows combined; a person can appear under more than one code. Shares are of all people with Part B in Original Medicare (women included), Utah 183,494 and U.S. 27,982,142, so the ratio column is the like-for-like comparison. The MRI code is also used for other pelvic MRIs, and leuprolide has other uses, so those rows are approximate. Source: CMS, Medicare Physician & Other Practitioners — by Geography and Service, 2024; CMS, Medicare Monthly Enrollment.

Share of people with Part B in Original Medicare who had each service billed in 2024; Utah bars solid, national bars lighter; bars scaled to the largest value. Source: CMS, Medicare Physician & Other Practitioners by Geography and Service, 2024.

The pattern repeats what we found for mammograms: fewer tests, more treatment. Utah runs 0.74 times the national rate for screening PSAs, 0.66 times for diagnostic ones and 0.73 times for the MRI, about the national rate for the biopsy itself (1.02), and then 1.52 times the national rate for radical prostatectomy, 1.19 times for the hormone injection and 4.73 times for brachytherapy, the implanted-seed radiation that a few Utah practices have specialized in. Some of that is Utah's higher incidence, which we turn to next; some is practice style. A Utah man who is biopsied is more likely to be treated, and more likely to be treated with surgery or seeds, than a man elsewhere. That is worth knowing before the first blood test, because the Task Force's whole argument is that the test's harms arrive downstream, in the biopsy and the treatment, and in Utah the downstream runs faster.

Why does Utah have more prostate cancer, and what does the registry show?

Utah's prostate cancer rate is above the nation's and climbing. The NCI and CDC's State Cancer Profiles put age-adjusted incidence at 129.6 new cases per 100,000 men a year for 2019–2023, against 119.9 nationally, 1.08 times the national rate and 16th highest of the 50 states and the District of Columbia, with 2,011 Utah men diagnosed a year, 1,377 of them 65 or older. The rate is rising 2.2% a year in Utah while the national rate is statistically flat, and among men 65 and older, the Medicare population, it is 734.7 against 644.4, 1.14 times the national rate, 11th highest, and rising 2.9% a year. The stage at diagnosis is better than the nation's: 20.4% of Utah prostate cancers are regional or distant when found, against 22.5% nationally, about 410 late-stage cases a year. And yet the death rate is higher, 21.5 per 100,000 men a year against 18.9, 8th highest in the nation, and 160.4 against 138.9 among men 65 and older, 5th highest; both Utah's and the nation's death rates are falling at about the same pace (-1.4% and −1.2% a year). 269 Utah men die of prostate cancer in an average year, 247 of them 65 or older. A higher incidence with an earlier stage and a higher death rate is an unusual combination; some of the higher incidence is more disease, some may be the diagnoses that follow treatment-heavy practice, and the registry cannot say which. What it does say is that a Utah man's lifetime odds of hearing the word are higher than an American man's.

Source: National Cancer Institute and CDC, State Cancer Profiles, prostate cancer, age-adjusted incidence 2019–2023 (all ages, ages 65+, and late stage) and death rates 2020–2024, November 2025 data submission — statecancerprofiles.cancer.gov.

The county table is the Wasatch Front's story more than rural Utah's. 17 of the 25 counties with enough cases to report a rate are above the national figure, and the highest are the northern suburban counties: Davis (168.3 per 100,000; 966.2 among men 65 and older, the highest in the state, rising 3.1% a year), Weber (159.7, rising 5.2% a year), Cache (147.4), Tooele (142.1) and Utah County (140.3, rising 3% a year). Salt Lake County, with the state's biggest urology practices, is below the national rate at 110.9, and Washington County, with the oldest population, is near it at 123.6. Where the registry can report a death rate, Davis (25.9), Utah County (23.6) and Uintah (23.4) are among the highest, and Davis pairs the state's highest incidence and one of its highest death rates with one of its lowest late-stage shares (15.6%, with Weber at 15.5%), which is the signature of a county that tests and treats a great deal. Grand County's late-stage share, 44%, is the state's highest, on a small number of cases, and Grand has no urologist.

Age-adjusted prostate cancer incidence per 100,000 men, all ages and ages 65 and older, 2019–2023, sorted highest to lowest; share of cases diagnosed at a regional or distant stage; age-adjusted death rate per 100,000 men, 2020–2024. “Suppressed” = 3 or fewer cases or deaths a year. United States: 119.9 cases, 644.4 at 65+, 22.5% late, 18.9 deaths. Source: NCI/CDC State Cancer Profiles, Utah counties — statecancerprofiles.cancer.gov (incidence), statecancerprofiles.cancer.gov (deaths).

Where can a Utah man see a urologist who takes Medicare?

The blood test is everywhere; the specialist is not. A screening PSA can be drawn at any clinic or hospital lab in the state on your own doctor's order, which is why the test itself is never the access problem. The work-up is. CMS's clinician file lists 88 clinicians with a Utah practice location whose primary specialty is urology, and 85 of them, 97%, accept assignment; the other 3 are non-participating and may charge up to 15% more than the approved amount on a visit or a biopsy. The 49 radiation oncologists listed in Utah all accept assignment. In 2024, 57 Utah clinicians billed a prostate biopsy from an office and 26 from a facility, and 33 billed a radical prostatectomy.

Clinicians with a Utah practice location whose primary specialty is urology, counted once per clinician in each city where a location is listed, so a urologist with offices in two towns appears in both and the area figures add to more than 88; a listed address is not a measure of how often the clinician is there. No urologist is listed with a practice address in Moab, Blanding, Monticello, Vernal, Price, Richfield, Delta or Panguitch. Source: CMS, Doctors and Clinicians National Downloadable File, retrieved October 8, 2026 — data.cms.gov.

For a man in Grand, San Juan, Uintah, Carbon, Emery, Sevier or Garfield County that means the biopsy, and any treatment, is a drive to the Wasatch Front, St. George or Cedar City, the same geography as a colonoscopy. Original Medicare does not care which Utah urologist you see or whether a referral exists; a Medicare Advantage HMO does, and the drive may be to the plan's network rather than the nearest practice. Radiation, which is daily for weeks in its external-beam form, is the treatment for which distance matters most, and one reason the brachytherapy figure above is as high as it is: a single-day seed implant in Salt Lake City is a different proposition from seven weeks of commuting from Moab. That is a medical conversation, but the geography belongs in it.

How do Medicare Advantage and Medigap each handle a PSA test and what follows?

More than half of Utah's Medicare population, 269,226 of 490,235 people in June 2026 (54.9%), is in a Medicare Advantage plan. Medicare.gov's rule is that these plans must cover everything Original Medicare covers, so the yearly screening PSA is covered, and a Medicare-covered preventive screening in network is the plan's $0 benefit too; most plans also charge nothing for an ordinary lab test. The differences start with the result. The urology visit is the plan's specialist copay, usually a flat amount per visit and, in an HMO, usually after a referral from your primary doctor. The MRI falls under the plan's copay for advanced diagnostic imaging, which is often one of the larger copays in the plan and is a common prior-authorization item; the biopsy falls under the plan's outpatient surgery or diagnostic procedure copay, which can be in the hundreds and may also need authorization; and treatment, whether a hospital stay with a daily copay, a course of radiation at a per-session copay, or hormone injections under the plan's Part B drug coinsurance, is where the plan's annual out-of-pocket maximum becomes the number that matters. Read the Evidence of Coverage lines for “physician specialist services,” “diagnostic radiology services (such as MRIs),” “outpatient hospital services” and “Medicare Part B drugs,” because that is where a Medicare Advantage prostate work-up and treatment are priced.

In Original Medicare with a Medigap policy, each bill is the Medicare amount described above, and the policy pays it. Plan G pays the 20% on the visits, the MRI, the biopsy, the pathology, the surgeon, the radiation and the injections, the Part A deductible for a hospital stay, and any excess charge, leaving you the $283 Part B deductible once a year; the PSA itself never touches it. Plan N pays the same except a copay of up to $20 per office visit, which a year of urology follow-ups can turn into a modest sum, and it does not cover excess charges, which matter only with the 3 non-participating urologists. Our Plan G vs. Plan N guide works through the difference, and the Medigap vs. Medicare Advantage guide covers the bigger choice. For a man with a rising PSA, a family history, or a diagnosis already on the chart, the predictability of Plan G is the argument; for a man whose yearly blood test is all he expects, it is a small part of the decision.

A Davis County example: a PSA that led to a biopsy

Consider a 66-year-old retired aerospace machinist in Layton, in Original Medicare without a Medigap policy, whose January wellness-visit bloodwork includes his screening PSA. It comes back above the level his doctor uses, so she repeats it six weeks later as a diagnostic test, and it is still high. He sees a urologist in Layton, who orders a prostate MRI at an imaging center; the MRI shows an area worth sampling, and an ultrasound-guided biopsy is scheduled in the hospital's outpatient department. It is still winter, so nothing has been applied to his $283 Part B deductible yet.

Illustrative; averages across all Utah claims for each code in 2024 and the Utah average hospital outpatient facility amount on the APC 5373 biopsy line, not a price quote. Sources: CMS, Medicare Physician & Other Practitioners by Geography and Service, 2024; CMS, Medicare Outpatient Hospitals by Geography and Service, 2024; CMS Claims Processing Manual, chapter 18.

Had the repeat PSA come back normal, the only lines would have been the first two, at $0.00 each. Had the biopsy been done in the urologist's office rather than the hospital, the last two lines would have been $383.80 in office fees and his total about $377.27. With Plan G he owes the $283 deductible and nothing else; with Plan N the same, plus up to $20 for each urology visit. In a Medicare Advantage plan he owes the plan's specialist copay for the visit, its advanced-imaging copay for the MRI and its outpatient procedure copay for the biopsy, which could be less or more than $667.10 depending on the plan, and the MRI and biopsy may have needed authorization. If the biopsy finds a cancer that needs treatment, a robot-assisted prostatectomy at 2024 Utah averages means the $1,736 Part A deductible for the stay plus 20% of the surgeon's $680.26, about $1,872 before anesthesia; a course of radiation is a series of Part B fees at 20%; and hormone injections run about $106 a quarter at 20%. That is the year a Medigap policy or a Medicare Advantage plan's out-of-pocket maximum earns its keep. If the biopsy finds a low-grade cancer, the most common plan today is active surveillance, which is a diagnostic PSA every few months at $0, periodic MRIs at 20%, and no treatment unless something changes.

What should a Utah man on Medicare actually do?

1. Decide about the test with your doctor, then let Medicare pay for it. Between 55 and 69 the Task Force's advice is a conversation first: a family history of prostate cancer, Black ancestry, or a strong preference for knowing argue for testing; a short life expectancy or a strong wish to avoid biopsies and treatment argue against. At 70 and older the Task Force recommends against routine screening; Medicare will still pay every 12 months if you and your doctor choose it. There is no wrong answer that Medicare will refuse to cover.
2. If you have the test, let the office bill it as a screening and expect to pay nothing. If a bill arrives for a PSA, screening or diagnostic, call the office or the lab; a clinical lab test cannot carry cost-sharing in Original Medicare, whatever the result. The only legitimate charge is from a non-participating doctor for drawing the blood.
3. Expect the work-up to cost money, and know roughly how much. A urology visit and an MRI are about $370.54 in approved charges at 2024 Utah averages: $74.11 if your deductible is met, all of it if not. Many high PSAs are an enlarged prostate or an infection, and a repeat test or an MRI often ends the matter; the bill is the price of the look, not a sign of cancer.
4. If a biopsy is needed, ask where it will be done. The same ultrasound-guided biopsy cost an Original Medicare patient about $77 in a Utah urologist's office in 2024 and about $367 in a hospital outpatient department, before pathology. Your urologist's judgment comes first, but the question is fair, and in a Medicare Advantage plan the copay difference may be larger.
5. If the biopsy finds cancer, ask about surveillance before treatment, and ask what each treatment costs you. Utah treats more of its prostate cancers with surgery and seeds than the nation does. For a low-grade cancer, active surveillance is a recognized option that costs almost nothing under Medicare; for one that needs treatment, the Part A deductible, the surgeon's 20% and the radiation fees are all predictable from the table above, and a Medigap policy turns them into the $283 deductible.
6. If you are in Medicare Advantage, get the referral and the authorization before the MRI and the biopsy. The PSA is $0 in network; the MRI in particular is a frequent prior-authorization item, and an out-of-network urologist can turn a covered biopsy into a denied one. Our appeals guide covers what to do if a plan says no.
7. Use the yearly Wellness visit to make the decision once, and write it down. Medicare pays for a yearly Wellness visit in which the doctor records the screenings you are due for and the ones you have decided against. “PSA: discussed, declined at 72” is as valid an entry as “PSA: yearly.”
8. Match your coverage to the year you might have. One $0 blood test a year is no reason to buy a Medigap policy. A rising PSA, a family history, a diagnosis under surveillance, or a treatment already planned is part of the calculation, and the Annual Enrollment Period (October 15 to December 7) is the time to make it.

Frequently asked questions

Sources

• Medicare.gov — Prostate cancer screenings (Part B covers digital rectal exams and PSA blood tests for men over 50, starting the day after the 50th birthday, once every 12 months; “you pay nothing for the PSA blood test”; the exam at 20% after the Part B deductible plus a hospital copay in a hospital outpatient setting; a non-assignment doctor may charge for services “but not for the test itself”): medicare.gov — prostate cancer screenings
• Medicare.gov — Diagnostic laboratory tests (Part B covers medically necessary diagnostic lab tests when a provider orders them; “you usually pay nothing for Medicare-covered diagnostic laboratory tests”): medicare.gov — diagnostic laboratory tests
• Medicare.gov — Does your provider accept Medicare as full payment? (assignment; non-participating providers; the 15% limiting charge): medicare.gov — assignment; Compare Original Medicare & Medicare Advantage (plans must cover all Part A and Part B services; networks and referrals): medicare.gov — compare
• 42 CFR 410.39 — Prostate cancer screening tests: conditions for and limitations on coverage (definitions of the screening exam and PSA test; who may order or perform them; once every 12 months for men who have attained age 50): ecfr.gov — 42 CFR 410.39
• CMS — Medicare Claims Processing Manual, chapter 18 (Preventive and Screening Services), section 50, Prostate Cancer Screening Tests and Procedures: coverage effective January 1, 2000 under sections 1861(s)(2)(P) and 1861(oo) of the Act as added by the Balanced Budget Act of 1997; once every 12 months once 11 full months have passed; “the screening PSA test is a lab test to which neither deductible nor coinsurance apply”; “both deductible (if unmet) and coinsurance are applicable to screening rectal examinations”; G0103 paid under the clinical diagnostic lab fee schedule; G0102 bundled into a same-day evaluation and management visit; code 0359U added effective January 1, 2023; diagnosis code Z12.5; the age and frequency edits: cms.gov — chapter 18 (PDF)
• CMS — 2026 Medicare Parts A & B Premiums and Deductibles, November 14, 2025 (Part B premium $202.90; Part B deductible $283; Part A deductible $1,736): cms.gov — 2026 premiums and deductibles
• CMS — Medicare Physician & Other Practitioners — by Geography and Service, calendar years 2024 and 2022 (Utah and National rows for G0103, 84153, 84154, G0102, 99204, 99214, 72197, 76872, 76942, 55700, 88305, 55866, 55875 and J9217; beneficiaries, clinicians, average approved and paid amounts by place of service): data.cms.gov — physicians by geography and service
• CMS — Medicare Outpatient Hospitals — by Geography and Service, calendar year 2024 (Utah and National APC 5373 rows for 55700: 207 Utah beneficiaries with a prostate biopsy in a hospital outpatient department at an average approved facility amount of $1,672.81; 53,709 nationally at $1,918.47): data.cms.gov — outpatient hospitals by geography and service
• CMS — Medicare Inpatient Hospitals — by Geography and Service, calendar year 2024 (MS-DRG 708, Major Male Pelvic Procedures without CC/MCC: 51 Utah discharges at an average Medicare payment of $10,768.57; 2,119 nationally at $9,953.50): data.cms.gov — inpatient hospitals by geography and service
• CMS — Medicare Monthly Enrollment (2024: 183,494 Utahns and 27,982,142 nationally with Part B in Original Medicare, 47.0% and 45.6% of all beneficiaries male; 2022: 197,316 and 29,655,517; June 2026: 490,235 Utah beneficiaries, 269,226 in Medicare Advantage, 221,009 in Original Medicare): data.cms.gov — monthly enrollment
• CMS — Doctors and Clinicians National Downloadable File, retrieved October 8, 2026 (88 Utah urologists, 85 accepting assignment; 49 radiation oncologists, 49 accepting assignment): data.cms.gov — doctors and clinicians
• U.S. Preventive Services Task Force — Prostate Cancer: Screening, final recommendation statement, May 8, 2018 (men 55 to 69: individual decision after discussing benefits and harms, grade C; men 70 and older: recommends against PSA-based screening, grade D): uspreventiveservicestaskforce.org
• National Cancer Institute and CDC — State Cancer Profiles, prostate cancer: age-adjusted incidence by state 2019–2023, all ages (Utah 129.6, U.S. 119.9) and ages 65+ (Utah 734.7, U.S. 644.4); late-stage incidence and share (Utah 27.1, 20.4%; U.S. 27.5, 22.5%); death rates 2020–2024, all ages (Utah 21.5, U.S. 18.9) and 65+ (Utah 160.4, U.S. 138.9); Utah counties: statecancerprofiles.cancer.gov — Utah counties, statecancerprofiles.cancer.gov — death rates
• Utah Insurance Department — Medicare consumer page (Utah SHIP (877) 424-4640): insurance.utah.gov

About this article. Written by the Utah Retirement Income Data Desk and reviewed by Brian Penner, Retirement income & long-term care planner. Educational only — not medical, financial, or legal advice, and not a recommendation of any specific plan, provider, facility, laboratory, test or treatment; whether, when and how often to be screened for prostate cancer, and what to do about a result, is a decision for you and your doctor. Coverage rules and cost-sharing are quoted from Medicare.gov, CMS, the Code of Federal Regulations and the U.S. Preventive Services Task Force as of October 8, 2026; the Utah and national beneficiary counts, shares and average amounts are our own tabulation of the CMS Physician & Other Practitioners, Outpatient Hospitals, Inpatient Hospitals, Doctors and Clinicians and Medicare Monthly Enrollment public use files, which count Original Medicare claims only, attribute each claim to the state of the clinician, laboratory or hospital, and are revised by CMS periodically; a person can appear under more than one billing code; the per-man screening rate applies the male share of all beneficiaries to Part B Original Medicare enrollment and is an estimate; the cancer figures are registry rates with the limitations noted on their source pages; the clinician counts are the CMS file as retrieved on that date. Average Medicare-approved amounts are averages across all claims and are not price quotes; Medicare Advantage copay descriptions are general and vary by plan; the example household is illustrative. What you will owe depends on your coverage, your doctor, the facility, how the test is ordered and billed, and whether each provider accepts assignment or is in your plan's network; confirm with your plan, your provider, or 1-800-MEDICARE before you act. Utah Retirement Income is a licensed independent insurance agency (NPN 16493717) and is not a government agency; we are not connected with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, the National Cancer Institute, the U.S. Preventive Services Task Force, the Social Security Administration, or any government program, and nothing here should be read as an endorsement by them. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area; please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program — in Utah, the Utah SHIP at (877) 424-4640 — to get information on all of your options. A $0-premium Medicare Advantage plan is not free; you still pay the Part B premium ($202.90 a month in 2026 for most people) and the plan's cost-sharing. Long-term care insurance and annuity guarantees depend on the claims-paying ability of the issuing company, with no promise of savings. If you call or text us, you consent to be contacted at the number you provide about your options; message and data rates may apply, and you can opt out at any time by replying STOP.