How Much Does A Baby Helmet For Plagiocephaly, Brachycephaly or Scaphocephaly Cost?

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Finding An Accurate Price For A Baby Helmet

If you want a quick answer to the question, a baby helmet is approximately $2000.00

However, your individual costs for that helmet can vary, so we hope that you will continue reading to find out why this number can change.

In our effort to be as accurate as possible in answering your question, we actually have to tell you that the price can fluctuate.  We realize that this might not be the answer you wanted to hear.  We know it can be somewhat frustrating to hear the answer presented to you in this way.  However, you will understand exactly why we state it this way by the end of this article.

The Cost For People With Insurance

Basically, the specialist who treats your son or daughter typically does not charge you cash for these helmets; they bill your insurance.  (Unless you do not have any form of insurance, which is the case sometimes and we will discuss this later in the article.)  The specialist seeing your son or daughter has to present the service rendered to your insurance in a specific way, as a result. Thus the existence of hcpc codes.

There is a special hcpc code assigned to these baby helmets and the orthotist (custom helmet provider) has to use it when providing this form of treatment.  That code is S1040.  The cost for that code, per one of the country’s most common insurance plans currently is : $ 2000.00

Each plan and each insurance company comes to this cost conclusion differently. So, if we gave you just one cost then it wouldn’t be fair to you.  It’s like going to get an ice cream cone at a restaurant.  Even if the restaurant was part of a chain, that same ice cream cone might come in at $1.00 at one location, but it might also cost $1.15 for the same exact thing in a neighboring town.

Your cost to pay at the visit though might be $0.00.  Or you might be asked to pay the full amount.  This part of your cost might be directly related to your deductible, for example.  If your deductible has been met, your cost might be absolutely nothing.  It is a case by case situation.  For cranial remolding helmets (baby helmets), it would be nice if the cost was always the same.  That way we could present it to you with a uniform answer.

But unfortunately, it falls into a second category.  The price your insurance has concluded they will pay for the item.  If your provider is in network with your plan, then they have to abide by the cost of that code, per your plan.

The Cost For People Without Insurance

The cost for individuals without insurance can vary even more.  However, now that you know what the cost is that we presented above, then you can shop around a little bit more.  Some providers, that know the patient does not have insurance might up the price.  Just to be really honest with you.  That’s because they might be banking on the fact that you do not know the real cost.  But, now you have a frame of reference and that helps.

A more ethical provider will match the usual and customary from other insurance providers and present you with that cost.  They should also present you with a payment plan if needed to help offset the cost a little bit.

What Services Typically Comes With The Cost Of The Helmet? 

The s1040 code is meant to be for a pediatric patient, with a rigid exterior and soft interface material.  And here is also a very important part of the description : “Includes Fitting and Adjustment”.

So, typically this includes the initial visit when your son or daughter is first seen.  This is often times when the patient is scanned or an impression is taken of the cranium.  It also includes a fitting and delivery visit when the child has the helmet customized to their size and shape even further.  Meaning, if the plastic is 1/4″ too long over the ear, this is trimmed down etc. The fitting and delivery visit is when the fine tuning happens for your son or daughter.

Also, baby helmets are special in that they require follow up treatment.  Why?  Because the babies head grows.  Along with the customization of the helmet after it has been fabricated, the price should include many follow up visits where the padding in the orthosis is slightly trimmed away so the head has more of a chance to grow in the desired direction.  The orthotist knows what to do because they can start to see the head pressing on the padding in a more definite way as they look at the helmet.

We hope this information has helped you.  If you have any questions, feel free to call us toll free at 1-866-RINELLA.

We have other blog posts on the topic of these helmets so make sure to check those out as well.  Good luck!

* Rinella Prosthetics & Orthotics, Inc. is not responsible for any price discrepancies you may encounter.  We believe the prices quoted here are very close to what you will expect to see, but if we cannot be responsible for what other practitioners may charge.

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    2020-08-25T11:39:07+00:00By |Categories: Uncategorized|