Medicare Guidelines for Hyperbaric Oxygen Therapy

Medicare covers hyperbaric oxygen therapy only for specific conditions and injuries, such as carbon monoxide and cyanide poisoning. The therapy must be a supplement to traditional treatment. If you meet all criteria, Medicare pays 80% of the cost for each hyperbaric oxygen therapy session you receive.

Rachel Christian, writer and researcher for RetireGuide
  • Written by
    Rachel Christian

    Rachel Christian

    Financial Writer and Certified Educator in Personal Finance

    Rachel Christian is a writer and researcher for RetireGuide. She covers annuities, Medicare, life insurance and other important retirement topics. Rachel is a member of the Association for Financial Counseling & Planning Education.

    Read More
  • Edited By
    Lee Williams
    Lee Williams, senior editor for RetireGuide.com

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

    Read More
  • Published: June 10, 2021
  • Updated: October 23, 2023
  • 4 min read time
  • This page features 7 Cited Research Articles
Fact Checked
Fact Checked

Our fact-checking process starts with vetting all sources to ensure they are authoritative and relevant. Then we verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page.

Cite Us
How to Cite RetireGuide.com's Article

APA Christian, R. (2023, October 23). Medicare Guidelines for Hyperbaric Oxygen Therapy. RetireGuide.com. Retrieved October 3, 2024, from https://www.retireguide.com/medicare/treatments/hyperbaric-oxygen-therapy/

MLA Christian, Rachel. "Medicare Guidelines for Hyperbaric Oxygen Therapy." RetireGuide.com, 23 Oct 2023, https://www.retireguide.com/medicare/treatments/hyperbaric-oxygen-therapy/.

Chicago Christian, Rachel. "Medicare Guidelines for Hyperbaric Oxygen Therapy." RetireGuide.com. Last modified October 23, 2023. https://www.retireguide.com/medicare/treatments/hyperbaric-oxygen-therapy/.

Why Trust RetireGuide.com
Why You Can Trust Us

Content created by RetireGuide and sponsored by our partners.

Key Principles

RetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.

We’re dedicated to providing thoroughly researched Medicare information that guides you toward making the best possible health decisions for you and your family.

RetireGuide LLC has partnerships with Senior Market Sales (SMS) and GoHealth.

Our partners are able to be reached through the phone numbers and/or forms provided on our website.

The content and tools created by RetireGuide adhere to strict Medicare and editorial guidelines to ensure quality and transparency.

Editorial Independence

While the experts from our partners are available to help you navigate various Medicare plans, RetireGuide retains complete editorial control over the information it publishes.

We operate independently from our partners, which allows the award-winning RetireGuide team to provide you with unbiased information.

Visitors can trust our inflexibility regarding our editorial autonomy. We do not allow our partnership to influence RetireGuide’s editorial content whatsoever.
Hyperbaric Oxygen Therapy Coverage at a Glance
Medicare PlanHyperbaric Oxygen Therapy Coverage
Part A (Inpatient)N/A
Part B (Outpatient)Pays 80% of the cost after you pay your deductible. But it only pays if you meet specific criteria.
Part C (Medicare Advantage)Mirrors Part B coverage but may offer additional benefits.
Part D (Prescription Drugs)N/A
Supplemental InsuranceMay cover some of the out-of-pocket costs Part B does not cover.

Is Hyperbaric Oxygen Therapy Covered By Medicare?

Medicare covers hyperbaric oxygen therapy for several conditions, but you must meet certain criteria to qualify.

The therapy must be administered in a chamber — including a one-person unit — in order for you to receive Medicare coverage.

Conditions That Qualify for Hyperbaric Oxygen Therapy Medicare Coverage
  • Acute carbon monoxide intoxication
  • Decompression illness
  • Gas embolism
  • Gas gangrene
  • Cyanide poisoning
  • Acute traumatic peripheral ischemia
  • Crush injuries and suturing of severed limbs
  • Progressive necrotizing infections
  • Acute peripheral arterial insufficiency
  • Preparation and preservation of compromised skin grafts

Medicare also covers hyperbaric oxygen therapy for a handful of other conditions — but only when it’s used as a supplement to conventional treatment.

Medicare will cover hyperbaric oxygen therapy as a supplement to traditional treatment for the following conditions:
  • Chronic refractory osteomyelitis that is unresponsive to conventional medical and surgical management
  • Osteoradionecrosis
  • Soft tissue radionecrosis
  • Actinomycosis — when the disease process is resistant to antibiotics and surgical treatments

Medicare also covers hyperbaric oxygen therapy if you have wounds on your lower body caused by diabetes. To qualify, your wounds must be classified as Wagner grade III or higher after a course of standard wound therapy has failed to improve your condition.

In most cases, Medicare doesn’t consider hyperbaric oxygen therapy the go-to treatment of choice. Rather, Medicare will pay for this type of supplement, or adjunct, therapy only after 30 days of standard wound therapy has failed to produce measurable signs of healing.

If you participate in hyperbaric oxygen as an adjunct therapy, you must undergo standard wound care at the same time.

Every 30 days, your wounds will be evaluated. Medicare will stop paying for hyperbaric oxygen therapy if you don’t show any measurable signs of healing within any 30-day period you receive the treatment.

Medicare Cost for Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy is covered by Medicare Part B. You will be responsible for 80% of the cost. The Part B deductible — $240 in 2024 — also applies.

You may owe less if you have supplement insurance, such as Medicaid or a Medigap policy.

Hyperbaric oxygen therapy typically takes place on an outpatient basis at a hospital or special clinic. You will typically pay more out of pocket if you receive therapy at a hospital.

Your doctor may recommend hyperbaric oxygen therapy for other reasons, but unless you have one of the conditions listed above, Medicare won’t pay for the treatment.

Common conditions that don’t qualify for Medicare reimbursement of hyperbaric oxygen therapy include:
  • Skin burns
  • Sickle cell anemia
  • Tetanus
  • Organ transplantation
  • Pulmonary emphysema
  • Exceptional blood loss anemia
  • Multiple Sclerosis
  • Arthritic diseases

The list above is not exhaustive, so confirm your benefits prior to receiving hyperbaric oxygen therapy.

Medicare also won’t pay for the topical application of oxygen. If you undergo this type of treatment, you will be responsible for 100% of the costs.

Have you selected your 2024 Medicare plan?
Maximize your Medicare savings by connecting with a licensed insurance agent. Annual Enrollment is open until December 7th.

What Is Hyperbaric Oxygen Therapy?

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized environment.

It began as a treatment for deep-sea divers suffering from decompression sickness, a painful and potentially deadly condition where gas bubbles accumulate in the blood.

The therapy is now used to treat several conditions, including serious infections and wounds resulting from diabetes or radiation injury that fail to heal.

During a hyperbaric session, patients lie on a bed in an enclosed tube containing high-pressure oxygen while a physician supervises.

Breathing 100% oxygen inside a pressurized chamber increases the amount of oxygen in a patient’s blood.

Increased oxygen levels in the blood are said to promote the growth of new blood vessels into the hypoxic tissues and enhance the body’s ability to kill certain bacteria.

The therapy often requires multiple sessions, each lasting about two hours. The number of sessions you require depends on your condition.

According to the Mayo Clinic, carbon monoxide poisoning may be treated in just three visits, while other conditions, such as nonhealing wounds, can require more than 40 sessions.

Medicare Coverage of Hyperbaric Oxygen Therapy FAQs

How much does Medicare reimburse for hyperbaric oxygen therapy?
As of 2018, Medicare reimbursed physicians $113.04 for each 30-minute session of hyperbaric oxygen therapy.
Does Medicaid cover hyperbaric oxygen therapy?
Medicare will cover hyperbaric oxygen therapy if you meet certain criteria. It will cover the therapy if you receive it in a chamber and you must be diagnosed with at least one of 15 specific conditions.
Does Medicare cover hyperbaric oxygen therapy for radiation cystitis?
Though it does not specifically list radiation cystitis, Medicare covers hyperbaric oxygen therapy for radiation injuries. Medicare covers HBOT for soft tissue radionecrosis. Check with Medicare or your Medicare Advantage plan provider to see if your case is covered.
Last Modified: October 23, 2023

7 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2022). Costs. Retrieved from https://www.medicare.gov/basics/costs/medicare-costs
  2. U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
  3. Mayo Clinic. (2020, October 28). Hyperbaric oxygen therapy. Retrieved from https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380
  4. United Healthcare. (2020, October 20). Hyperbaric Oxygen Therapy. Retrieved from https://web.archive.org/web/20220901055332/https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-coverage-sum/hyperbaric-oxygen-therapy-macs.pdf
  5. Galewitz, P. (2017, June 28). Medicare flags overuse of hyperbaric therapy for diabetics due to questionable value. Retrieved from https://www.healthcarefinancenews.com/news/medicare-flags-overuse-hyperbaric-therapy-diabetics-due-questionable-value
  6. Medicare.gov. (n.d.). Hyperbaric oxygen therapy. Retrieved from https://www.medicare.gov/coverage/hyperbaric-oxygen-therapy
  7. U.S. Centers for Medicare & Medicaid Services. (n.d.). National Coverage Determination (NCD) for Hyperbaric Oxygen Therapy (20.29). Retrieved from https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=12&ver=3