California mandates insurance coverage for FDA-cleared scalp cooling

California has enacted Assembly Bill 1682, becoming the largest state to require insurance coverage for FDA-cleared scalp cooling for cancer patients receiving chemotherapy. The law could speed access to a treatment that helps reduce hair loss and offers other states a model for coverage.

Why it matters: - California’s new law expands insurance coverage for scalp cooling, a treatment that can reduce chemotherapy-induced hair loss. - The measure may lower out-of-pocket costs for patients who previously had to self-pay for treatment. - The law gives other states a coverage template as more legislatures consider similar bills.

What happened: - California enacted Assembly Bill 1682 and Gov. Gavin Newsom signed it on Sept. 27. - The law requires insurance coverage for FDA-cleared scalp cooling for cancer patients undergoing chemotherapy. - California becomes the largest state to adopt a scalp cooling coverage law to date. - The state joins New York, Louisiana, Maryland, West Virginia and Connecticut in enacting scalp cooling coverage legislation.

The details: - AB 1682 defines covered scalp cooling as FDA-cleared devices and systems. - The law expands access through large-group commercial insurance and Medi-Cal, California’s Medicaid program. - The legislation includes protections intended to limit patient out-of-pocket costs. - California’s bill followed clinical, economic and regulatory review, including analysis of how the coverage mandate fits with Affordable Care Act Essential Health Benefits rules. - The California Health Benefits Review Program found strong evidence that FDA-cleared automated scalp cooling systems reduce chemotherapy-induced hair loss and do not increase the risk of scalp metastasis. - California already has more than 45 cancer centers offering Paxman and DigniCap Scalp Cooling Systems. - Paxman and DigniCap systems are available in more than 900 cancer centers across the United States. - The National Comprehensive Cancer Network recommends scalp cooling as a Category 2A treatment option for patients receiving chemotherapy.

Between the lines: - The law matters beyond California because it ties coverage to FDA-cleared technology and an existing reimbursement pathway for provider-delivered scalp cooling. - Three Category I CPT® codes for mechanical scalp cooling took effect Jan. 1, 2026, giving providers a standardized way to bill insurers for scalp cooling services. - In New York and Louisiana, Paxman says reimbursement has become more consistent as providers use the new codes. - Paxman’s Insurance-Based Billing Model lets participating providers bill insurers directly instead of asking patients to pay upfront and seek reimbursement later. - The model also gives eligible uninsured and underinsured patients access to Paxman’s Patient Assistance Program. - Richard Paxman said the company has worked across the access pathway, from clinical evidence and FDA clearance to coding, reimbursement and provider implementation. - Paxman said California offers other states a practical framework for scaling coverage.

What’s next: - Paxman is working with legislators, clinicians, patient advocates and other stakeholders in key states to advance similar coverage measures. - The company expects experience from states with active mandates to help shape implementation in new markets. - As more states consider coverage laws, the focus is shifting from whether scalp cooling should be covered to how coverage can work for patients and providers.

The bottom line: - California’s new mandate turns scalp cooling from a mostly self-pay service into a more mainstream covered benefit and could accelerate adoption nationwide.