Paxman Scalp Cooling is available throughout the United States. For system locations, please visit our Global Systems Locations Index.
Since scalp cooling achieved FDA clearance in 2017 and was subsequently included within the NCCN guidelines, Paxman’s vision has always been to ensure equitable access to the treatment for all. Everyone should be able to feel like themselves.
Despite rapidly growing demand for scalp cooling in the US, disparity in access to this essential treatment remains. Cancer doesn’t discriminate based on individual financial circumstances. Data shows significant financial debt from out-of-pocket expenses resulted in decreased Quality of Life. This is sadly most common in disadvantaged and underrepresented populations who must choose between their wellbeing or financial stability. Historically, self-pay was the only option for scalp cooling, making it financially inaccessible for many.
However, reimbursement is now a firm reality with Paxman’s Insurance-Based Billing Model (IBBM). This means you have the power to help those going through cancer treatment to access scalp cooling without financial toxicity. All it takes is a simple switch to show your commitment to patient-centric care.
Use the navigation menu to explore everything you need to know about the simple switch and how to get started.
Did you know?
Paxman's Insurance-Based Billing Model is already in place in many of the top hospitals and cancer centers across the country.
The Paxman Insurance-Based Billing Model (IBBM)
Making your mark on accessible patient-centric care for all starts with Paxman’s IBBM. The model allows your facility to directly bill insurance (via Cat I CPT codes) and comes with a range of benefits for you and your facility, as well as for patients. With the IBBM you can:
Category I CPT Codes Now Available for Mechanical Scalp Cooling
The American Medical Association (AMA) has assigned Category I CPT Codes for Mechanical Scalp Cooling effective January 1, 2026. This means that providers can directly bill mechanical scalp cooling on behalf of their patients.
With Category I status, RVUs (Relative Value Units) are assigned, allowing transparent Medicare/Medicaid reimbursement under the 2026 Physician Fee Schedule and OPPS. This makes it even easier to secure coverage for your facility and your patients.
Be Prepared: Legislative Bills on Reimbursement
In 2024, New York State signed a bill to mandate insurance payment for scalp cooling, also effective January 1, 2026. Since then, numerous others have followed suit, starting a chain reaction of bills now under consideration across the Eastern Seaboard. Louisiana became the second state to pass a bill in 2025.
These bills, campaigned for by oncology key opinion leaders, alongside patient advocates, show a growing need and desire for patient-centric care that treats the person, not just the cancer. People with a cancer diagnosis will prefer facilities that offer reimbursement.
Now is your chance to join your peers and get ahead of the curve. It’s time for the Simple Switch.
The American Medical Association (AMA) has assigned Category I CPT Codes for Mechanical Scalp Cooling which came into effect January 1, 2026. This means thattreatment facilities contracted under the Paxman Insurance-Based Billing Model (IBBM) can now bill mechanical scalp cooling via Category I CPT codes on behalf of their patients.
Concerned about your patients getting coverage? Even with temporary Category III CPT coding, Paxman has seen excellent patient coverage in recent years.
Only providers using the full Paxman Hub services are included in this data set – June 2022 to January 2025
Category I CPT codes effective January 1, 2026
With CPT I codes now available and legislative bills on the way, coverage outcomes will improve even further. This means more patients, more consistent coverage and higher payment rates.
Treatment facilities contracted under the Paxman Insurance-Based Billing Model (IBBM) can now bill mechanical scalp cooling via Category I CPT codes
What happens in the event where a patient is underinsured or uninsured?
This is where Paxman’s generous Patient Assistance Program (PAP) comes in. This acts as a safety net, catching anyone who meets the eligibility criteria.
The Paxman Patient Assistance Program* assists patients who:
Patients at or below 600% of the federal poverty level receive a cap kit free of charge if they are un- or underinsured. A free-of-charge replacement cap kit will be provided by Paxman. The provider will not charge the patient for the cap kit or any scalp cooling treatments.
Automatic Qualification into the PAP
If EITHER of these criteria are met, a patient will automatically qualify into the Paxman PAP: Patient has an adjusted gross income of less than or equal to 600% of the Federal Poverty Level based on HHS Hardship waiver available if product is >50% of household income.
Conditional Qualification into the PAP
*The PAP is only available to facilities who are contracted under Paxman’s Insurance-Based Billing Model.
For the period June 2022 to January 2025, 90% of patients did not pay out-of-pocket due to positive coverage or support from the Paxman Patient Assistance Program.
You’re just a few clicks away from making the simple switch to Insurance-Based Billing. Here’s how to get started delivering equitable, streamlined, patient-centered cancer care:
1. Contact Paxman
Reach out to the team via the contact form to express your interest. From here on in, you’ll have the full support of our experienced team to guide you through the rest of the process.
2. Set up a contract*
After giving you a deeper dive into the IBBM, we’ll guide you through the process of signing a contract with Paxman and our distributor to place your order of cap kits.
3. Training & Integration
Your staff will receive comprehensive training on billing for scalp cooling treatments via CPT Category I codes.
4. Start Offering Scalp Cooling
Once you’re set up, you can begin billing insurance for cap fittings and treatments, leading the way for a new age of equitable access for scalp cooling.
*Facilities may not directly bill insurance without a contract in place due to the negative impact on potential patient reimbursement.
Here you will find everything you need as part of the Insurance-Based Billing Model. Remember: our team will guide you through the entire process.
Christina Arnal, RN, BSN, OCN talks through switching her institution’s self-pay model to an insurance-based billing one, as patient demand increases.
Medical Oncologist and Associate Director for Clinical Research at MGH Cancer Center Steve Isakoff, MD, PHD Introduction to the Simple Switch Webinar, Setting the scene with background on the current position of access to scalp cooling across the United States
Prepared by Oncologist Anna Litvak, MD, presented by Karin Buck exploring the financial toxicity and the importance of equitable access to scalp cooling, Category I CPT codes and the implications for broadening patient access to this important means of side-effect management, how the adoption of insurance-based billing ahead of 2026 can accelerate patient access, and the implementation of insurance-based billing for scalp cooling.
How nurses can help others see the value of switching to insurance-based billing, what sites should consider when implementing IBBM, including the challenges and practicalities drawn from real-world experiences, and the patient impact, from a more streamlined process to reducing out-of-pocket expenses.
Category I CPT codes take full effect
New York and Louisiana have mandated coverage for scalp cooling starting January 1,2026
Yes. Cooling increments should be a full 30 minutes.
The only cost of switching is purchasing cap kits, so that you have them in inventory to provide to patients. Your facility will need to execute an amendment or new contract prior to making the switch.
That is possible but not a common practice when Category I CPT Codes come into effect from January 1, 2026. That would be more likely with the current (temporary) Category III CPT Codes.
We don’t receive that data from our customers. Additionally, the data would reflect information on the current (temporary) Category III CPT Codes which is vastly different than Category I CPT Codes.
In 2026, the Category I CPT Codes will be available and will be more widely reimbursed.
If your practice contracted with Paxman under the insurance-based billing model, you will purchase caps from our distributor and directly bill patient insurance. via Cat I CPT Codes.
If your site is offering our traditional self-pay business model, the cost is based on the number of treatments the patient receives. From June 1st, 2025, treatments 1 through 4 are $370 each, treatments 5 through 6 are $200 each, and treatments 7 through 12 are $120 each. Pricing is capped at $2600 – patients will pay no more than this, no matter how many cycles they receive.
Practices contracted under the insurance-based billing model will have access to the Patient Assistance Program offered by Paxman.
There are also a number of foundations across the country that may be able to help patients cover at least some of the costs of scalp cooling. Each foundation has different criteria as to who they support, often based upon the Federal Poverty Level, though this is not always the case. Patient information on Financial Support and Foundation is available here.
Paxman is encouraging practices to contract to the insurance-based billing model, which allows them to directly bill patient insurance. Otherwise, patients will need to pay for scalp cooling out-of-pocket. They may attempt to get reimbursed from their insurance company.
The Paxman Hub will assist with self-pay patients when a site is contracted with Paxman to bill a patient’s insurance company. If you would like to learn more about billing insurance, contact our expert team: reimbursement@paxmanusa.com
After an initial discussion with your patient to introduce scalp cooling, please refer them to our website coldcap.com. This online resource has been designed to help patients reach an informed choice about whether scalp cooling is right for them, then guide them through their treatment. There is also a range of patient education available to order here
After an initial discussion with your patient to introduce scalp cooling, please refer them to our website coldcap.com. This online resource has been designed to help patients reach an informed choice about whether scalp cooling is right for them, then guide them through their treatment. There is also a range of patient literature available to order from our Communications Catalogue, including a patient handout, an introduction to scalp cooling leaflet, and information on foundations and financial support.
Yes. Our US team is available to come back on site and answer questions, meet with all members of the care team, and provide additional training to new staff as well as refresher training for those needing to be re-familiarized with the fitting and treatment process.
Our website Coldcap.com is there to help patients make an informed choice, and guide them through their scalp cooling treatment. Knowing if cold capping is right for them is a decision only the patient can make. Coldcap.com will lay out everything patients need to know about Paxman scalp cooling to enable them to make an informed decision, and then go on to support them through the scalp cooling process.
Resources include:
