A7035 HCPCS code: Headgear used with positive airway pressure device
A7035 is the HCPCS Level II code for headgear used with positive airway pressure device. The 2026 Medicare DMEPOS fee schedule pays $22.56 to $38.30 (NU, new equipment, purchased) depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers. Its average fee ranks 24 of 37 A70 codes billed NU (family range $0.71–$172.96); rural fees run 50% higher.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2003-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for A7035
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $22.56 | $38.30 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $36.55 | — |
| AL | NU | $22.89 | $35.62 |
| AR | NU | $22.89 | $35.41 |
| AZ | NU | $22.56 | $37.23 |
| CA | NU | $23.12 | $37.23 |
| CO | NU | $23.37 | $35.50 |
| CT | NU | $24.43 | $35.75 |
| DC | NU | $22.92 | $37.23 |
| DE | NU | $22.92 | $34.58 |
| FL | NU | $22.89 | $34.12 |
| GA | NU | $22.89 | $34.99 |
| HI | NU | $38.20 | — |
| IA | NU | $22.97 | $37.23 |
| ID | NU | $23.37 | $37.23 |
| IL | NU | $23.02 | $37.23 |
| IN | NU | $23.02 | $37.23 |
| KS | NU | $22.97 | $37.23 |
| KY | NU | $22.89 | $35.20 |
| LA | NU | $22.89 | $36.05 |
| MA | NU | $24.43 | $35.66 |
| MD | NU | $22.92 | $37.23 |
| ME | NU | $24.43 | $36.08 |
| MI | NU | $23.02 | $37.23 |
| MN | NU | $22.97 | $37.23 |
| MO | NU | $22.97 | $37.23 |
| MS | NU | $22.89 | $35.41 |
| MT | NU | $23.37 | $37.23 |
| NC | NU | $22.89 | $34.78 |
| ND | NU | $22.97 | $37.23 |
| NE | NU | $22.97 | $37.23 |
| NH | NU | $24.43 | $34.58 |
| NJ | NU | $22.92 | $34.58 |
| NM | NU | $22.56 | $35.30 |
| NV | NU | $23.12 | $37.23 |
| NY | NU | $22.92 | $34.58 |
| OH | NU | $23.02 | $37.23 |
| OK | NU | $22.56 | $35.25 |
| OR | NU | $23.12 | $37.23 |
| PA | NU | $22.92 | $34.58 |
| PR | NU | $38.30 | — |
| RI | NU | $24.43 | $34.58 |
| SC | NU | $22.89 | $35.20 |
| SD | NU | $22.97 | $37.23 |
| TN | NU | $22.89 | $35.79 |
| TX | NU | $22.56 | $34.12 |
| UT | NU | $23.37 | $37.23 |
| VA | NU | $22.89 | $37.23 |
| VI | NU | $34.49 | — |
| VT | NU | $24.43 | $35.42 |
| WA | NU | $23.12 | $37.23 |
| WI | NU | $23.02 | $37.23 |
| WV | NU | $22.89 | $37.23 |
| WY | NU | $23.37 | $37.23 |
How the A7035 fee compares
| Measure | Value |
|---|---|
| Rank among 37 A70 codes billed NU (lowest = 1) | 24 |
| Family fee range (average of state fees) | $0.71–$172.96 |
| Rural fee uplift | 49.7% |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Published Contractor Policy |
What changed for A7035
- 2026-01-01: Average state fee (NU) rose 2.6%: $23.56 to $24.18
- 2003-01-01: A7035 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A7035?
A7035 is the HCPCS Level II code for headgear used with positive airway pressure device. Short descriptor: "Pos airway press headgear".
How much does Medicare pay for A7035?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $22.56–$38.30. Rural fees can be higher.
Does Medicare cover A7035?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A7035 change in 2026?
The average non-rural state fee for NU moved from $23.56 in 2025 to $24.18 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A7035 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related A70 codes
- A7000 — Canister, disposable, used with suction pump, each ($9.24–$13.39)
- A7001 — Canister, non-disposable, used with suction pump, each ($40.06–$47.58)
- A7002 — Tubing, used with suction pump, each ($3.87–$5.47)
- A7003 — Administration set, with small volume nonfiltered pneumatic nebulizer, disposable ($1.86–$3.26)
- A7004 — Small volume nonfiltered pneumatic nebulizer, disposable ($1.51–$2.08)
- A7005 — Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable ($11.77–$29.20)
- A7006 — Administration set, with small volume filtered pneumatic nebulizer ($8.19–$14.94)
- A7007 — Large volume nebulizer, disposable, unfilled, used with aerosol compressor ($3.47–$5.87)
- A7008 — Large volume nebulizer, disposable, prefilled, used with aerosol compressor ($12.46–$18.09)
- A7009 — Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer ($54.00–$66.77)
- A7010 — Corrugated tubing, disposable, used with large volume nebulizer, 100 feet ($17.61–$27.19)
- A7011 — Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet
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Next steps
- Run a reimbursement report for a device billed under A7035
- Watch A7035 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7035
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.