Not all DEXA machines have the option of TBS software. In my area it was plain DEXA. My score of severe osteoporosis (-3.8 and -3.6 for two vertebrae) seemed off because of the big variance between low and high scores. Plus I fell several times after the scan and nothing broke despite my doctor telling me I was very fragile. I got a REMS and scored as osteopenia. The doctor looked at my DEXA scan and said it was done wrong. Whether the tech positioned me wrong, or my vertebrae distorted the x-ray, or the machine wasn't calibrated correctly, I don't know. As of 2024, Medicare didn't cover the REMS procedure. Mine cost $150. Medicare did cover the doctor's cost, both the initial visit and a follow-up consult. If there is a DEXA machine near you with TBS, you have to ask for TBS beforehand, they don't automatically provide it. The doctor who oversaw my REMS said he was comfortable with me getting a DEXA scan again but only with TBS. It's easier for me to do the REMS so that is what I will continue to do. Here is a link to a REMS locator. I don't know if all providers are doctors. I felt comfortable using the relatively new technology because it was offered by an orthopedist who is becoming somewhat of an expert on the equipment in the US: https://www.echolightmedical.com/en/find-your-rems-center-in-usa/