TL;DR: Aetna, a CVS Health company, modified CPB 0290 for scalp cooling (hypothermia) to prevent chemotherapy-induced hair loss, effective February 27, 2026. CPT codes 0662T, 0663T, 97007, 97008, and 97009 are not covered. Here's what billing teams need to know.
If your oncology practice or infusion center offers scalp cooling services, this Aetna scalp cooling coverage policy update is a billing problem waiting to happen. The position is blunt: Aetna treats cooling caps and scalp cooling products as incidental to chemotherapy administration. They won't reimburse these services separately. Billing 0662T, 0663T, 97007, 97008, or 97009 on an Aetna claim is a straight path to claim denial.
Quick-Reference Table
| Field | Detail |
|---|---|
| Payer | Aetna, a CVS Health company |
| Policy | Scalp Cooling (Hypothermia) to Prevent Hair Loss During Chemotherapy |
| Policy Code | CPB 0290 |
| Change Type | Modified |
| Effective Date | February 27, 2026 |
| Impact Level | High |
| Specialties Affected | Oncology, Hematology/Oncology, Infusion Centers, Hospital Outpatient |
| Key Action | Remove CPT 0662T, 0663T, 97007, 97008, and 97009 from your Aetna charge capture immediately |
Aetna Scalp Cooling Coverage Criteria and Medical Necessity Requirements 2026
The core of this Aetna scalp cooling coverage policy is a non-coverage determination. Aetna does not recognize scalp cooling as a separately reimbursable service. The payer classifies it as incidental to chemotherapy administration — meaning it's bundled, not billable.
This matters because CPT codes 0662T and 0663T were specifically created to capture mechanical scalp cooling services. The AMA assigned these codes to describe scalp cooling procedures in detail. Aetna's position rejects that clinical distinction entirely.
The same applies to CPT codes 97007, 97008, and 97009. These codes describe mechanical scalp cooling services — including cap fitting, placement, monitoring, therapy initiation, and post-chemotherapy sessions billed per 30 minutes. Aetna will not reimburse any of them. There's no medical necessity pathway that unlocks coverage. Prior authorization won't help here either — this isn't a prior auth issue. The service is categorically excluded from separate reimbursement.
For plans that exclude supplies, Aetna also considers cooling caps purchased by the patient to be excluded supplies. That means members can't get reimbursed for the cap itself under those plan structures either. Review your patient's benefit plan description before assuming any coverage applies.
Aetna Scalp Cooling Exclusions and Non-Covered Indications
This policy is essentially all exclusion. There is no covered indication for separately billed scalp cooling under CPB 0290 in the Aetna system.
Every scalp cooling CPT code in this policy lands in the "not covered for indications listed in the CPB" group. That language is Aetna's way of saying the denial reason traces back to the policy itself — not to a missing diagnosis, a documentation gap, or a prior authorization failure. You can't fix a bundling exclusion with better paperwork.
The real issue here is that the FDA clearance of scalp cooling devices — and CMS's own recognition of these codes on the fee schedule — doesn't obligate commercial payers like Aetna to cover them. Aetna's coverage policy runs on its own track. FDA clearance and CMS recognition tell you a code exists. They don't tell you Aetna pays for it.
If your oncology practice has been billing these codes and receiving payment from Aetna, audit those claims now. A payer audit that finds consistent payment of non-covered services can trigger recoupment. Don't wait for that letter to arrive.
Coverage Indications at a Glance
| Indication | Status | Relevant Codes | Notes |
|---|---|---|---|
| Mechanical scalp cooling — initial measurement and cap calibration | Not Covered | 0662T | Considered incidental to chemo; not separately reimbursed |
| Mechanical scalp cooling — cap placement, monitoring, and removal | Not Covered | 0663T | Considered incidental to chemo; not separately reimbursed |
| Scalp cooling — cap fitting and patient education | Not Covered | 97007 | Considered incidental to chemo; not separately reimbursed |
| Scalp cooling — hair prep, cap placement, therapy initiation, monitoring, removal | Not Covered | 97008 | Considered incidental to chemo; not separately reimbursed |
| Scalp cooling — post-chemotherapy sessions (per 30 min) | Not Covered | 97009 | Considered incidental to chemo; not separately reimbursed |
| Cooling cap or scalp cooling product purchased by member | Not Covered (supply exclusion) | N/A | Excluded under plans that exclude supplies; see benefit plan |
| Chemotherapy administration | Covered (separate benefit) | 96401–96450 | Scalp cooling incidental to these services; not billable separately |
Aetna Scalp Cooling Billing Guidelines and Action Items 2026
This policy became effective February 27, 2026. If you haven't already acted, act now.
| # | Action Item |
|---|---|
| 1 | Remove CPT codes 0662T, 0663T, 97007, 97008, and 97009 from your Aetna charge capture. These codes will not be reimbursed when billed to Aetna for any patient. Delete them from your Aetna-specific fee schedules and charge masters. Don't leave them available for coders to select by mistake. |
| 2 | Audit claims submitted to Aetna since February 27, 2026. If your team billed any of the five scalp cooling CPT codes to Aetna on or after the effective date, pull those claims now. Identify any that were paid in error. Talk to your compliance officer before deciding how to handle overpayments — voluntary disclosure has different implications than waiting for a payer audit. |
| 3 | Audit claims submitted before February 27, 2026. This policy was modified, not created new. Check what the prior version of CPB 0290 said about coverage. If your team billed these codes under a prior version believing coverage applied, document your rationale. If Aetna paid those claims and the prior policy supported billing, that's a different situation than billing under the current version. |
| 4 | Review patient financial counseling scripts for scalp cooling. If your practice helps patients access scalp cooling systems, you need to update what you tell them about Aetna coverage. Patients with Aetna plans should know upfront that scalp cooling billing will not be covered and that they'll likely pay out of pocket. This is a patient relations issue as much as a billing one. |
| 5 | Check individual plan documents before billing. Aetna's note about supply exclusions is plan-specific. Some Aetna plans exclude supplies broadly, which means even a member-purchased cooling cap gets no reimbursement. Other plans may handle supplies differently. Always verify the member's specific benefit plan description before making assumptions about any coverage. |
| 6 | Don't bill scalp cooling costs into the chemotherapy administration codes. It might be tempting to fold the cost of scalp cooling services into the 96401–96450 chemotherapy administration codes as a workaround. Don't do it. That's upcoding. The chemotherapy administration codes have their own specific billing guidelines, and adding services to inflate those charges creates a false claim risk. |
| 7 | Talk to your compliance officer if you're uncertain about your prior billing patterns. Scalp cooling billing is a newer area — these CPT codes haven't been around long. If your team billed 97007, 97008, or 97009 under the assumption that FDA clearance meant payer coverage, that's a common error, but it's still an error. Get ahead of it with your compliance officer now. |
| Previous Version | Current Version |
|---|---|
| Coverage is considered experimental and investigational for all indications | Coverage is considered medically necessary when specific criteria are met |
| Prior authorization is not required | Prior authorization is required for initial treatment |
| Documentation must include clinical history | Documentation must include clinical history |
| Re-review every 24 months | Re-review every 12 months with updated clinical documentation |
CPT, HCPCS, and ICD-10 Codes for Scalp Cooling Under CPB 0290
Not Covered CPT Codes — Scalp Cooling
These codes are explicitly excluded from separate reimbursement under Aetna CPB 0290. Do not bill these to Aetna.
| Code | Type | Description |
|---|---|---|
| 0662T | CPT | Scalp cooling, mechanical; initial measurement and calibration of cap |
| 0663T | CPT | Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for chemotherapy administration) |
| 97007 | CPT | Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education |
| 97008 | CPT | Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, monitoring, and device removal |
| 97009 | CPT | Provided after discontinuation of chemotherapy, each 30 minutes (List separately in addition to code for primary service) |
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