Bone mineral density (BMD) measurement using dual-energy x-ray absorptiometry (DXA) numbers, performance location, and interpreters have changed from 2003-2013.1 Several factors have impacted DXA utilization in the United States over the last 15 years. Notably, the 2007 reduction in DXA reimbursement by the Centers for Medicare and Medicaid Services (CMS) resulted in an overall decrease in DXA testing and a shift from office to hospital based settings.2, 3, 4, 5, 6 The reduction in office-based practices has led to limited DXA access, especially in rural settings.2,7 Other studies have shown a link between changes in reimbursement policy, screening intervals and DXA utilization.8, 9, 10 At least in part due to limited access, a 2016 review of CMS data documented a sustained decline in DXA testing with a shift in interpreting providers from non-radiologists to radiologists.1 It is important to recognize that, over this same time period, the number of fracture liaison services (FLS) has increased.11,12 Compared to routine post-fracture care, FLS programs increase BMD testing.11, 12, 13, 14, 15 Given these changes in provision of osteoporosis care, the purpose of this study was to provide updated trends in DXA utilization rates, place of service, and interpreter specialty for the Medicare fee-for-service population.