A8002 Medicare Reimbursement Rate (2026)
Current CMS pricing and breakdown for ~Soft protect helmet custom.
National Average Payment
Non-Facility (Private Office) Rate
A8002 Reimbursement Rate History
| Quarter | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | — | — | — | — | — | — |
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Code Description
Helmet, protective, soft, custom fabricated, includes all components and accessories
Reimbursement Summary
CPT code A8002 (Helmet, protective, soft, custom fabricated, includes all components and accessories) does not currently have a published national facility or non-facility reimbursement rate in 2026.
A8002 is a HCPCS Level II code in the category “DMEPOS Equipment.” Medicare does not publish a single national payment amount for this code in 2026 (No National Rate). A national base rate is not currently published.
To estimate a local payment amount when available, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage and confirm final pricing guidance through CMS or your local Medicare Administrative Contractor (MAC).
A8002 Reimbursement Rate History
| Quarter | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | — | — | — | — | — | — |
Historical Medicare Reimbursement
No published quarterly historical rates are available yet for this code.
| Quarter | Non-Facility Rate | Facility Rate | YoY % Change (Non-Fac) | YoY % Change (Fac) |
|---|---|---|---|---|
| 2026 Q2 | — | — | — | — |
| 2026 Q1 | — | — | — | — |
| 2025 Q4 | — | — | — | — |
| 2025 Q3 | — | — | — | — |
| 2025 Q2 | — | — | — | — |
| 2025 Q1 | — | — | — | — |
Commercial Payer Rates for A8002
Pro FeatureNational average reimbursement from major commercial payers based on CMS Transparency in Coverage machine-readable files.
| Modifier | Place of Service | Avg. Rate | vs Medicare | Percentile Range |
|---|---|---|---|---|
| NULL | Office (11) | $91.46 | -4.0% | $80 — $104 |
| NULL | Telehealth (02) | $88.20 | -7.4% | $76 — $102 |
| NULL | Facility (21) | $79.31 | -15.6% | $68 — $95 |
| NULL | Outpatient Hospital (22) | $84.92 | -10.2% | $71 — $99 |
| NULL | Home (12) | $96.14 | +1.0% | $84 — $113 |
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Source: CMS Transparency in Coverage machine-readable files (MRFs). Commercial rates reflect payer-published negotiated amounts and may not reflect individual contracted rates.
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Facility vs. Non-Facility (Office) Payment
Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For A8002 (DMEPOS Equipment), the payment methodology may not include both facility and non-facility rates.
Q2 2026 Breakdown
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | ||
| Practice Expense (PE) | ||
| Malpractice (MP) | ||
| Total RVUs | 0.00 | 0.00 |
Learn How This Reimbursement Is Calculated
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
Frequently Asked Questions
What is the 2026 Medicare rate for A8002?
Medicare does not publish a single national reimbursement rate for A8002 in 2026 (No National Rate). Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool to explore locality-adjusted estimates when applicable.
What is the description for code A8002?
Helmet, protective, soft, custom fabricated, includes all components and accessories
Why do facility and non-facility payments differ for A8002?
Facility vs. non-facility differences usually apply to RVU-based physician services. A8002 may not use both facility and non-facility pricing depending on its payment methodology.
How can I find my local Medicare rate for A8002?
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Is A8002 covered by Medicare?
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.
