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A8000 — Helmet, protective, soft, prefabricated, includes all components and accessories

HCPCS Level II A-code · short descriptor: “Soft protect helmet prefab”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Inexpensive or routinely purchased
Prior authorization
Not on Medicare required-PA list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

A8000 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $218.57 to $262.20 depending on state and rural status.

Former-CBA payment limits: ceiling $218.57 · floor $185.78

StateNon-ruralRural
AK$218.57
AL$218.57
AR$218.57
AZ$218.57
CA$218.57
CO$218.57
CT$218.57
DC$218.57
DE$218.57
FL$218.57
GA$218.57
HI$218.57
IA$218.57
ID$218.57
IL$218.57
IN$218.57
KS$218.57
KY$218.57
LA$218.57
MA$218.57
MD$218.57
ME$218.57
MI$218.57
MN$218.57
MO$218.57
MS$218.57
MT$218.57
NC$218.57
ND$218.57
NE$218.57
NH$218.57
NJ$218.57
NM$218.57
NV$218.57
NY$218.57
OH$218.57
OK$218.57
OR$218.57
PA$218.57
PR$262.20
RI$218.57
SC$218.57
SD$218.57
TN$218.57
TX$218.57
UT$218.57
VA$218.57
VI$218.57
VT$218.57
WA$218.57
WI$218.57
WV$218.57
WY$218.57

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $21.86 to $26.21 depending on state and rural status.

Former-CBA payment limits: ceiling $21.86 · floor $18.58

StateNon-ruralRural
AK$21.86
AL$21.86
AR$21.86
AZ$21.86
CA$21.86
CO$21.86
CT$21.86
DC$21.86
DE$21.86
FL$21.86
GA$21.86
HI$21.86
IA$21.86
ID$21.86
IL$21.86
IN$21.86
KS$21.86
KY$21.86
LA$21.86
MA$21.86
MD$21.86
ME$21.86
MI$21.86
MN$21.86
MO$21.86
MS$21.86
MT$21.86
NC$21.86
ND$21.86
NE$21.86
NH$21.86
NJ$21.86
NM$21.86
NV$21.86
NY$21.86
OH$21.86
OK$21.86
OR$21.86
PA$21.86
PR$26.21
RI$21.86
SC$21.86
SD$21.86
TN$21.86
TX$21.86
UT$21.86
VA$21.86
VI$21.86
VT$21.86
WA$21.86
WI$21.86
WV$21.86
WY$21.86

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $163.97 to $196.69 depending on state and rural status.

Former-CBA payment limits: ceiling $163.97 · floor $139.37

StateNon-ruralRural
AK$163.97
AL$163.97
AR$163.97
AZ$163.97
CA$163.97
CO$163.97
CT$163.97
DC$163.97
DE$163.97
FL$163.97
GA$163.97
HI$163.97
IA$163.97
ID$163.97
IL$163.97
IN$163.97
KS$163.97
KY$163.97
LA$163.97
MA$163.97
MD$163.97
ME$163.97
MI$163.97
MN$163.97
MO$163.97
MS$163.97
MT$163.97
NC$163.97
ND$163.97
NE$163.97
NH$163.97
NJ$163.97
NM$163.97
NV$163.97
NY$163.97
OH$163.97
OK$163.97
OR$163.97
PA$163.97
PR$196.69
RI$163.97
SC$163.97
SD$163.97
TN$163.97
TX$163.97
UT$163.97
VA$163.97
VI$163.97
VT$163.97
WA$163.97
WI$163.97
WV$163.97
WY$163.97
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related A-codes

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