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A8003 Medicaid reimbursement rates by state

Helmet, protective, hard, custom fabricated. 17 state Medicaid programs publish a fee-for-service rate for A8003 at the clinical nurse specialist level. Rates run from $15.33 in Hawaii to $800.00 in Georgia, with a median of $375.35.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
17
Median rate
$375.35units vary by state
Highest
$800.00Georgia
Medicare (non-facility)
—not on the physician fee schedule

A8003 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$800.00since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$483.48since 2010-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$468.58since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$446.20since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$441.26since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$430.26since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$426.00since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$400.68since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$375.35since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$360.58since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$303.66since 2021-09-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$294.48since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$275.00since 2008-03-15——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$265.41since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$201.60since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$181.30since 2014-05-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$15.33since 2024-03-04——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched

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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for A8003?

It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $375.35. Georgia pays the most ($800.00) and Hawaii the least ($15.33).

Which state pays the highest Medicaid rate for A8003?

Georgia, at $800.00, effective 2016-07-01.

Do managed-care plans pay the same rate for A8003?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

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