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Billing code A8001 · Equipment & supplies

A8001 Medicaid reimbursement rate by state (2026)

Helmet, protective, hard, prefabricated. Medicaid pays a median of $153.35 for A8001 across 49 states, from $14.08 in Rhode Island to $256.69 in North Dakota.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$153.35units vary by state
Lowest
$14.08Rhode Island
Highest
$256.69North Dakota
Answer

What does Medicaid pay for A8001?

49 state Medicaid programs publish a fee-for-service rate for A8001. The national median is $153.35 (units differ between states). North Dakota pays the most, $256.69, and Rhode Island the least, $14.08, a 18.2x spread.

State ranking

A8001 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1North Dakota Source · since 2026-07-01$256.69——Not classified—
2Arizona Source · since 2026-10-01$234.76——Plans negotiate; applies out of network—
3Washington Source · since 2026-07-01$218.57——Plans negotiate; applies out of network—
24Georgia Source · since 2016-07-01$153.35——Plans negotiate; applies out of network—
25Texas Source · since 2007-01-01$153.35——Plans negotiate; applies out of network—
26Arkansas Source · since 2025-06-04$153.35——Not classified—
48Oregon Source · since 2024-10-01$16.74——Plans negotiate; applies out of network—
49Rhode Island Source · since 2012-07-01$14.08——Plans negotiate; applies out of network—
See all 49 states for A8001 — start free

41 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track A8001 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for A8001, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 26 of the 49 states list more than one rate for A8001, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 49 states, 3 publish A8001 per unit, and 46 schedules print no unit at all (a flat amount per service).
  • Per hour. A8001 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for A8001, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why A8001 rates differ between states

Published rates for A8001 run from $14.08 in Rhode Island to $256.69 in North Dakota, a 18.2x gap in the same unit. Half the states pay more than the median of $153.35 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.

Timing matters too. 28 states set the current rate for A8001 in 2026 or later, while 14 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for A8001

What a plan pays for A8001 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 49 states.

In 10 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 22 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 17 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (22 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (8 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
  • The state sets the plan rate (2 states). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example North Dakota managed care.

Billing

Units and billing for A8001

A8001 is a HCPCS Level II transportation and supply code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. A codes cover ambulance and transportation services and medical and surgical supplies. Transport codes are paid per trip or per mile; supply codes per item or per box as the code states.

Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for A8001?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $153.35. North Dakota pays the most ($256.69) and Rhode Island the least ($14.08).

Which state pays the highest Medicaid rate for A8001?

North Dakota, at $256.69, effective 2026-07-01.

Which state pays the lowest Medicaid rate for A8001?

Rhode Island, at $14.08, effective 2012-07-01.

What unit is A8001 billed in?

Of the 49 states, 3 publish A8001 per unit, and 46 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for A8001?

Not necessarily. In 10 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 22 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 17 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.