The CT Scan. The VirtuOst BCT test analyzes data in an existing CT scan that contains the hip and/or lower spine. Therefore, the patient needs to have had such a CT scan before ordering a VirtuOst test. Typically, that’s a CT scan the patient has had within the previous one or two years for some other medical reason, such as an abdominal-pelvic scan for stomach pain or a lumbar spine scan for low back pain. If deemed medically necessary by their physician, a patient can have a new CT scan taken specifically for the purposes of a BCT test, which they can get at their chosen imaging facility. O.N. Diagnostics does not perform any CT scanning.

The Order Form. A physician order is needed. The VirtuOst Order Form needs to be signed by both the physician and patient and then faxed to O.N. Diagnostics. O.N. Diagnostics will then retrieve the patient’s CT scan from the imaging facility, analyze it, and send the results back to the ordering physician.

That’s it. Because the VirtuOst service is fully remote, it is available nationwide and the patient does not need to undergo any additional imaging procedure or visit any test facility.

O.N. Diagnostics will arrange to retrieve the patient’s CT scan from the imaging facility where it was taken. Just provide the required information on the VirtuOst Order Form.

For details, see VirtuOst CT Scan Selection. In short, almost any hip-containing CT scan can be used; and most scans of the abdomen or lower spine (T12 or below) can be used if the slice thickness is 3 mm or less and if they do not contain IV contrast. IV contrast is not an issue for hip-containing scans or for VFA analysis.

Scans cannot be analyzed if metal implants reside at the same transverse cross-section as the bone to be analyzed. Thus, no hip implant for a hip analysis; for a spine analysis, we need one level between T12 and L3 that is implant free. If you send us a scan that we cannot analyze, you will not be charged.

In some cases, a physician may consider it medically necessary to have a new CT specifically for a BCT test (CPT code 0558T, also nationally covered by Medicare with waiver of copayment and deductible, as part of the Bone Mass Measurement benefit). There are various scan acquisition options to consider for such a dedicated scan. Typically, a protocol similar to that for a low-dose abdominal-pelvic scan is sufficient for a hip and spine analysis, or a protocol similar to that for a low-dose lumbar spine scan for a spine-only analysis. For more information, see VirtuOst CT Scan Selection.

The VirtuOst Results report is returned to the ordering physician via secure fax. In addition, the ordering physician and/or patient can request that results are returned via secure email.

Reimbursement for VirtuOst depends on what type VirtuOst test and what type of insurance, if any, you have.

For VirtuOst BCT, if you are in traditional Medicare: If you are in traditional Medicare ("Part B") and meet coverage criteria, there is no charge. On the VirtuOst Order Form, provide all the required information, including both sides of your Medicare insurance card and copies of any supplementary insurance. O.N. Diagnostics will file for reimbursement.

Private Insurance / Medicare Advantage: At present O.N. Diagnostics does not file reimbursement claims with any private insurers. Thus, if you are in Medicare Advantage ("Part C"), you will need to self-pay O.N. Diagnostics and optionally submit your own reimbursement claim to your insurer using the invoice from O.N. Diagnostics. Medicare Advantage is required to cover all services provided by traditional Medicare, although you may be subject to copayment if your plan considers BCT to be out of network. Check with your insurance. If you are not in any form of Medicare, coverage for BCT varies across insurance plans. Check with your plan.

Who is covered? For diagnostic testing, VirtuOst BCT is reimbursed nationally (NCD 150.3) by Medicare under its preventive service for Bone Mass Measurement, with waiver of copayment and deductible. To be reimbursed by Medicare as a Bone Mass Measurement, the patient must meet Medicare’s coverage criteria:

• An estrogen deficient woman (post-menopausal) who is at risk for osteoporosis based on her medical history and other findings.
• An individual with vertebral abnormalities, as demonstrated by an X-ray to be indicative of osteoporosis, low bone mass, or vertebral fracture.
• An individual receiving (or about to receive) glucocorticoid therapy equivalent to an average of ≥ 5.0 mg of prednisone/day for ≥ 3 months.
• An individual with primary hyperparathyroidism.

In addition, Medicare only covers one type of Bone Mass Measurement test (either DXA, BCT, CT, or ultrasound) once every two years. The date of service for BCT is the day the BCT analysis is performed, not the day the underlying CT scan was taken. Medicare does not cover BCT for monitoring osteoporosis drug treatments. If BCT is used to diagnose osteoporosis, Medicare will cover a baseline DXA for monitoring purposes.

For VirtuOst BCT with concurrent VFA (CPT code 0743T): BCT with concurrent VFA is reimbursable by traditional Medicare if considered medically necessary, but not under the Bone Mass Measurement benefit. Thus, the above coverage criteria do not apply, nor does the waiver of copayment and deductible.

Category III CPT^® Codes^† for BCT and BCT with concurrent VFA:

In typical use, retrieval and transmission of the scan data to a centralized testing lab (0555T) is performed by a Radiology department or imaging facility; assessment of bone strength and fracture risk and bone mineral density (0556T) is performed by the centralized testing facility at O.N. Diagnostics; and interpretation and report (0557T) is performed by a physician with expertise in osteoporosis and BCT. Such a physician would typically be the same type of physician who has the medical expertise to interpret results from DXA testing. For BCT with concurrent VFA, a single code (0743T) is used for all steps and modifiers can be used for only the technical ("-TC") and professional ("-26") components. VFA is not available as a stand-alone test. For situations in which either BCT or BCT with concurrent VFA is medically indicated and a patient does not have a previous CT scan that can be utilized for the test, a CT scan can be ordered (0558T) solely for the purposes of an accompanying BCT.

†CPT Copyright 2018 American Medical Association. All rights reserved. CPT^® is a registered trademark of the American Medical Association. Please note that the use or reprinting of CPT content in any product or publication requires a license. For more information about the licenses available, see CPT License Information. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

If you intend to self-pay, indicate that on the VirtuOst Order Form. Individuals in traditional Medicare who decide to self-pay must fill out and sign the ABN Form and check the appropriate box to indicate they are choosing to self-pay and do not want O.N. Diagnostics to submit a reimbursement claim. O.N. Diagnostics will bill you once the test results are sent to your ordering physician.

Self-Pay Patient Rates for VirtuOst BCT and BCT with VFA, 2026

If you are getting a new CT scan specifically for BCT, these costs do not include the costs of that scan. O.N. Diagnostics does not perform any CT scanning.

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