Dignitana

Dignitana AB announces today that the US Centers for Medicare & Medicaid Services (CMS) has published the OPPS Final Rule with an increase in the average rate for CPT® 0662T from $1250.50 to $1750.50 under the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) payment system for Calendar Year (CY) 2025.

This is a 39.98 percent increase from the 2024 rate and is also higher than the rate posted earlier this year in the 2025 CMS Proposed Rule.

"This is another strong step forward for scalp cooling reimbursement and important progress toward our overall goal to ensure scalp cooling is available to all patients. The increased rate provides greater financial support to providers and improves financial access for Medicare-eligible patients," said Dignitana CEO Fredrik Jonsson.

"Our reimbursement strategy focuses on the development of clear coding, coverage, and payment from both public and private payers. On the public payer side, this CMS rate increase, coupled with last month's important coding news that the American Medical Association issued three new Category I CPT® codes for scalp cooling to take effect in 2026, are strong indicators that scalp cooling is quickly advancing toward standard of care. This emphasizes the importance of Dignitana's Buy and Bill model which allows our providers to receive fair and reasonable reimbursement for the service they provide," Jonsson said.

Based on the number of claims submitted to CMS in 2023, CPT® Category III code 0662T was designated as a low volume service and as such, falls under the universal low volume Ambulatory Payment Classification (APC) policy.  APCs are based on clinical similarity, resource use, and cost.

The 0662T payment rate was initially set at $1350.50 in the Proposed Rule for CT 2025. However, after reviewing additional claims data from 2023, CMS increased the rate to $1750.50 in the Final Rule for CY 2025.

Current Procedural Terminology (CPT®) codes identify medical procedures and services performed by health care professionals and allow practices to bill correctly. The OPPS and ASC payment system are linked Medicare systems that determine how much hospitals and surgical centers receive for outpatient care.

There is a second CPT® Category III code for scalp cooling, 0663T, which is not currently payable by CMS, and that code is not affected by this announcement.

The FDA-cleared DigniCap Scalp Cooling System is clinically proven to minimize hair loss from chemotherapy for cancer patients with solid tumors such as breast, ovarian and prostate cancer. DigniCap is available in over 260 infusion centers across the US and over 30 countries worldwide. Scalp cooling is a treatment recommendation in the clinical practice guidelines published by National Comprehensive Cancer Network® (NCCN), European Society for Medical Oncology (ESMO), and Cancer Australia.