Navigating Insurance Coverage for Scalp Cooling

If you are considering scalp cooling to help manage hair loss during chemotherapy, understanding your insurance options is an important step. While navigating insurance coverage has historically been complex, the landscape is shifting to make the process more structured.

What is Changing?

Effective January 1, 2026, mechanical scalp cooling has transitioned to Category I CPT® codes.

• What this means: Healthcare providers now have standardized, universally recognized billing codes to report scalp cooling services/supplies to insurance companies.

• What this does NOT mean: A CPT code does not guarantee automatic coverage. Insurance plan benefits still vary, and coverage decisions are ultimately made by your specific insurer.

  
  

How to Check Your Coverage

Because every insurance plan is unique, we highly recommend contacting your insurance provider directly before starting treatment. Here are the key questions to ask them:

• Is mechanical scalp cooling covered under my plan? (You can share that your provider may use the new 2026 CPT codes: 97007, 97008, and 97009).

• Do I need prior authorization before starting treatment? (We highly recommend asking your care team to submit a prior authorization request to confirm you meet your insurer's medical necessity guidelines.) 

• Are there any out-of-pocket costs, such as deductibles or co-pays, that I should expect?

  
  

Note on State Mandates: Some states have introduced or passed laws requiring certain insurance plans to cover scalp cooling. Your clinical care team or insurance company is the best resource for understanding the specific rules in your state.

How Cooler Heads Can Support You

Navigating insurance can feel overwhelming, but you don't have to do it alone. The Cooler Heads team offers reimbursement support to help your healthcare provider explore your coverage options for the Amma™ scalp cooling system. Have questions about using Amma , contact our Support Team today.

*These new billing codes do not guarantee coverage or payment. Coding and reimbursement information prepared by Cooler Heads is for informational purposes only. This information is not an affirmative instruction as to which codes and modifiers to use for a particular service, supply, procedure, or treatment. It is the provider's responsibility to determine and submit the appropriate codes for services rendered. Payer policies, coding requirements, and payments vary and are updated or changed over time. Providers should check and verify current policies and requirements with the payer for any particular patient. CPT codes and descriptions are copyright 1995-2026 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).