Paxman announces that CMS has finalized the 2026 Medicare payment rates for mechanical scalp cooling under the Hospital Outpatient and Physician Fee Schedule.
Prenumeration
Beskrivning
| Land | Sverige |
|---|---|
| Lista | First North Stockholm |
| Sektor | Hälsovård |
| Industri | Medicinteknik |
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Paxman announces, the US Centers for Medicare & Medicaid Services (CMS) issued Final Rules finalizing changes for Medicare payments under the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment (ASC) and the Physician Fee Schedule for Calendar Year 2026.
The payment rates for three new Category I CPT® Codes 97007, 97008, and 97009 for mechanical scalp cooling, effective January 1, 2026, are detailed below:
| Category I CPT codes for mechanical scalp cooling and brief description | APC | OPPS CY 2026 Rates | MPFS CY 2026 Rates | Example: MPFS rate for 6 treatments* |
| 97007 - Initial cap fitting and patient education | 1517 | $1,516 | $1,883.43 per patient, per treatment cycle | $1,883.43 |
| 97008 - Pre-cooling period | N/A | N/A | $55.80 per treatment | $334.80 |
| 97009 - Post-infusion cooling, per each 30 minute period | N/A | N/A | $32.31 per unit, per treatment | $775.44 |
*Average number of treatments per patient is six. Average post infusion cooling time is up to 120 minutes.
The mechanical scalp cooling device must be a medical device as defined by the US Food and Drug Administration (FDA), with treatment ordered and performed by trained clinical staff under the supervision of a physician or other qualified health care professional in an office or facility setting. These codes are not applicable if the treatment is self-administered by the patient. Category III CPT Codes 0662T and 0663T will be deleted effective January 1, 2026.
Richard Paxman, CEO, stated, “Despite strong support and advocacy from many providers, the rates remain as originally proposed, with no revisions. While the lack of change from the proposed rule is disappointing, we remain committed to navigating the complex U. S. insurance reimbursement landscape. We will continue our intensive efforts, not only to educate providers but also to work closely with our expert partners to address the packaging of the codes under OPPS.
Our long-term goal is to expand patient access to scalp cooling, and therefore our focus remains to ensure providers receive fair reimbursement for providing this treatment.
We are confident that this will not slow or hinder our momentum, and it is important to recognise that each development represents a positive step in the right direction.”
Learn more about Paxman’s Scalp Cooling System: www.paxmanscalpcooling.com