Helmet, protective, soft, prefabricated, includes all components and accessories
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 0 units per day (clinical), rationale: CMS Policy
DME supplier: max 0 units per day (clinical), rationale: CMS Policy
Medicare pricing for A8000
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $218.57 in the contiguous states; $218.57 to $262.20 in AK, HI, PR and VI; ceiling $218.57, floor $185.78
RR (rental), inexpensive or routinely purchased (IN): non-rural $21.86 in the contiguous states; $21.86 to $26.21 in AK, HI, PR and VI; ceiling $21.86, floor $18.58
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $163.97 in the contiguous states; $163.97 to $196.69 in AK, HI, PR and VI; ceiling $163.97, floor $139.37
Physician Fee Schedule (CY 2026, RVU26D)
Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for A8000
1 of 1 payer prior-auth lists that name A8000 require prior authorization or set conditions: Blue Shield of California Promise Health Plan.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.