Yes. In most cases, you can pay for an MRI, CT scan or other imaging test with money from a health savings account (HSA) or a health flexible spending account (FSA). Imaging done to diagnose or treat a medical problem counts as a qualified medical expense under IRS rules. Here’s what’s covered, the gray areas and how to keep your records in order.
Key takeaways
- MRI, CT, X-ray, ultrasound, mammography and PET scans for medical care are generally HSA and FSA eligible.
- You can use your account for your deductible, coinsurance, copays or a self-pay cash price.
- The IRS lists «an electronic body scan» as a medical expense, but your FSA administrator may still ask for proof that a scan was medical care.
- Keep itemized receipts. You may need them for your plan or for the IRS.
- In 2026, you can put up to $4,400 (self-only) or $8,750 (family) in an HSA, and up to $3,400 in a health FSA.
What the IRS says
HSAs and FSAs can pay for qualified medical expenses, which IRS Publication 502 defines as the costs of diagnosis, cure, mitigation, treatment or prevention of disease. That publication specifically includes:
- X-rays for medical reasons.
- Diagnostic tests by a physician.
- Laboratory fees that are part of medical care.
- The cost of an electronic body scan.
It also says expenses that are merely beneficial to general health don’t count.
In practice, imaging tests your doctor orders, such as an MRI of your knee or a CT of your abdomen, fit clearly within the rules.
What you can pay for with an HSA or FSA
| Imaging cost | Usually eligible? |
|---|---|
| MRI, CT, X-ray, ultrasound ordered by your doctor | Yes |
| Mammogram, DEXA bone density scan | Yes |
| PET/CT and nuclear medicine scans | Yes |
| Your deductible, copay or coinsurance for a scan | Yes |
| A self-pay (cash) price for a scan | Yes |
| The radiologist’s reading fee | Yes |
| Contrast dye given as part of the scan | Yes, as part of the service |
| An elective full-body scan without symptoms | Gray area (see below) |
| Your health insurance premiums | Usually no (with exceptions, such as some Medicare premiums for HSAs) |
What about elective full-body MRI or CT scans?
This is the gray area. IRS Publication 502 lists «an electronic body scan» as a medical expense, which suggests these scans can qualify. Some full-body scan companies say their scans are HSA and FSA eligible for that reason.
But the IRS also says expenses merely beneficial to general health don’t qualify, and plan administrators set their own documentation rules. Some FSA administrators ask for a letter of medical necessity before they’ll approve the claim.
If you’re considering an elective scan:
- Ask your HSA or FSA administrator before you pay.
- Keep the receipt and any doctor’s recommendation.
- Talk with your doctor about whether the scan makes sense for you. Medical groups disagree about screening full-body scans for people without symptoms.
HSA vs. FSA: key differences for imaging
| HSA | Health FSA | |
|---|---|---|
| Who can open one | People with an HSA-compatible health plan | People whose employer offers one |
| 2026 contribution limit | $4,400 self-only, $8,750 family | $3,400 |
| Money rolls over | Yes, every year, and it’s yours to keep | Usually no. Plans may allow a carryover of up to $680 or a short grace period |
| Money available | Only what you’ve put in so far | Your full yearly amount from the start of the plan year |
The FSA’s up-front funding can help if you have an expensive scan early in the year. The HSA is better for saving for future scans.
New for 2026: Under the One Big Beautiful Bill Act, bronze and catastrophic plans count as HSA-compatible starting January 1, 2026. If you buy coverage on the Marketplace, you may now be able to open an HSA.
How to pay for your scan
- Pay with the account’s debit card at the imaging center, if your plan offers one.
- Or pay yourself and get reimbursed. Submit an itemized receipt to your administrator.
- Keep records. Save the itemized bill or receipt, your insurer’s Explanation of Benefits (EOB) and, for elective scans, any letter of medical necessity.
For an HSA, you can usually reimburse yourself years later for a qualified expense, as long as you had the HSA when the expense happened and you kept the receipt.
What happens if you use the money for something that isn’t eligible
With an FSA, the administrator will deny the claim or ask you to repay it.
With an HSA, a non-qualified withdrawal counts as taxable income. If you’re under 65, you’ll usually owe an extra 20% tax as well.
Frequently asked questions
Can I use my HSA for an MRI if I’m on Medicare? You can’t contribute to an HSA once you’re enrolled in Medicare, but you can still spend money already in the account on qualified medical expenses, including imaging.
Can I use an HSA or FSA for a family member’s scan? Yes, generally for your spouse and tax dependents.
Do I need a doctor’s order to use my HSA for an MRI? The IRS doesn’t require a doctor’s order for every expense, but most MRIs and CT scans need one anyway. For elective scans, documentation helps if you’re ever asked.
Is a cash price cheaper than using insurance? Sometimes. HSA money works for either. Compare your expected cost under your plan with the imaging center’s self-pay price.
Sources
- Internal Revenue Service: Publication 502, Medical and Dental Expenses (2025).
- Internal Revenue Service: Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans.
- Internal Revenue Service: Rev. Proc. 2025-32 (2026 inflation-adjusted amounts).
- Internal Revenue Service: IR-2025-119, HSA changes under the One Big Beautiful Bill Act.
This article is for general information only and isn’t tax advice. Check with your HSA or FSA administrator, or a tax professional, about your situation.