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
+ 4 more indications

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

This policy is now in effect (since 2026-02-27). Verify your claims match the updated criteria above.

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 more action items

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

Sample Version Diff Line-by-line changes
Previous VersionCurrent Version
Coverage is considered experimental and investigational for all indicationsCoverage is considered medically necessary when specific criteria are met
Prior authorization is not requiredPrior authorization is required for initial treatment
Documentation must include clinical historyDocumentation must include clinical history
+ 1 more action items

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

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
+ 2 more codes

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

Get the Full Picture

Track this policy across versions, search 1,500+ policies by CPT code, and get real-time alerts when any payer changes coverage.

🔍 Search by any code 🔔 Real-time alerts 📊 Line-by-line diffs ⏰ Deadline tracking
Get Full Access → $99/mo · 14-day money-back guarantee