DEXA scans in Philadelphia measure bone mineral density (the standard medical use) or whole-body composition (the longevity use). Bone density DEXA is widely covered by insurance for women over 65 and select younger patients. A whole-body composition DEXA is $100 self-pay through Fishtown Medicine's imaging partners, takes about 15 minutes, and the result comes back to Dr. Ash to read with you rather than sitting in a portal. Fishtown Medicine orders bone density DEXA at baseline for patients in or after the menopausal transition and serial body composition DEXA for patients tracking muscle preservation, weight loss, or training response. To get one, start the intake and Dr. Ash takes it from there.
DEXA (dual-energy X-ray absorptiometry) is the standard imaging method for measuring bone mineral density. The same machine, set to a different protocol, also measures whole-body composition with high accuracy. Most patients in Philadelphia have heard of the bone-density use; many have not realized the body-composition use exists at the same imaging centers.
This page covers both: what each is, when to get one, where to get one in Philadelphia, and how Fishtown Medicine integrates DEXA into ongoing primary care.
Bone density DEXA: who needs one
Standard indications for bone density DEXA:
- All women age 65 and older.
- Postmenopausal women under 65 with risk factors: prior fragility fracture, family history of hip fracture, body weight under 127 lb, current smoker, chronic glucocorticoid use, hyperthyroidism, hyperparathyroidism, certain medications.
- Men age 70 and older.
- Men 50-70 with risk factors.
- Anyone with a prior low-trauma fracture in adulthood.
- Patients on long-term glucocorticoids or anti-androgen therapies.
We often recommend a baseline bone density DEXA for women in or after the perimenopausal transition (typically late 40s to early 50s) even if not yet at the standard cutoff. The fastest bone loss happens in the years around menopause, and a baseline before that window is informative for the long-arc plan.
Standard sites measured: lumbar spine, hip (femoral neck and total hip), sometimes forearm.
Results are reported as T-score (compared to young healthy adult population) and Z-score (compared to age-matched population). T-score above -1.0 is normal; -1.0 to -2.5 is osteopenia; below -2.5 is osteoporosis.
Body composition DEXA: what it measures
Whole-body DEXA measures three things with high accuracy:
- Lean mass. Total and regional (arms, legs, trunk).
- Fat mass. Total, regional, and percentage.
- Visceral fat (in modern scanners). Specifically the fat around your internal organs, which is the metabolically dangerous fraction.
The accuracy is substantially better than BMI, calipers, or bioelectrical impedance (BIA) methods.
Body composition DEXA is useful for:
- Tracking lean mass during weight loss (particularly on GLP-1 medications).
- Tracking training response and muscle gain.
- Measuring visceral fat as a metabolic risk marker.
- Setting baseline for longevity planning.
- Verifying that a weight-loss plan is preserving lean mass.
Where to get a DEXA scan in Philadelphia
Most major Philadelphia hospital systems (Penn, Jefferson, Temple, Cooper, Main Line Health) offer bone density DEXA at their radiology centers. Most also offer whole-body composition DEXA on a self-pay basis. Standalone imaging centers in Philadelphia also offer both.
What it costs through our imaging partners:
- Bone density DEXA: usually covered by insurance when the standard indications apply.
- Whole-body composition DEXA: $100 self-pay, with no markup from the practice.
Fishtown Medicine
A 90-minute conversation with Dr. Ash. A written plan you can actually follow.
We maintain a current list of preferred imaging partners, send the order electronically, and the results come back to Dr. Ash rather than sitting unread in a portal.
How DEXA fits into Fishtown Medicine's preventive workup
We typically order:
- Baseline bone density DEXA for women in or after the perimenopausal transition (late 40s-early 50s) and for men over 60 with risk factors.
- Serial bone density DEXA every 2-3 years for patients in the osteopenia range or on osteoporosis treatment, every 5 years for patients with normal bone density.
- Body composition DEXA at baseline for patients starting a serious longevity plan, weight-loss plan, or training program. Serial scans every 6-12 months when useful.
We integrate DEXA results into the broader prevention plan: bone density informs hormone therapy and bisphosphonate decisions; body composition informs training, nutrition, and weight-management plans.
How do I get a DEXA scan through Fishtown Medicine?
The path is short, and it starts with the intake rather than a phone call: tell Dr. Ash what you are tracking and where you want to end up. He reads every intake himself, and from there you pick the path that fits:
- One-time baseline. The Audit is the single deep-dive visit: Dr. Ash orders your body composition DEXA ($100 self-pay at the imaging center) alongside advanced labs, then reads all of it with you in one unhurried sitting and hands you the plan. One fee, no subscription.
- Tracking over time. Membership fits when the scan is a baseline you intend to repeat: serial DEXA every 6 to 12 months, the training and nutrition plan adjusted as the numbers move, and Dr. Ash a text away in between.
Either way, the scan itself is billed by the imaging center (insurance-covered for bone density when indicated, $100 self-pay for body composition), the order and any insurance paperwork come from us, and the interpretation is part of your visit rather than an upsell. Once your intake is in and you have picked your path, scheduling comes straight to you and the free call with Dr. Ash walks through how it all fits together.
Key Takeaways
- DEXA measures bone density (standard medical use) or whole-body composition (longevity use) depending on protocol.
- Bone density DEXA is often insurance-covered for standard indications; body composition DEXA is $100 self-pay through our imaging partners.
- DEXA is substantially more accurate than BIA or calipers for body composition.
- Fishtown Medicine integrates DEXA results into ongoing primary care.
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Frequently Asked Questions
Common Questions
Deep-Dive Questions
Ready when you are
Dr. Ash reads every intake himself, and answers questions personally - usually within a few hours.
