The BARIC Score: How to Rate Any HBOT Clinic in 5 Minutes

The BARIC Score is a five-criteria framework for evaluating any HBOT clinic in the United States. Each criterion scores 0 to 2 points, for a maximum of 10. A score of 8 or above indicates a clinic worth your time and money. Below 5, keep looking.

What Is the BARIC Score?

HBOT clinics range from UHMS-accredited hospital programs with board-certified hyperbaric physicians to strip-mall wellness centers with a soft chamber and a weekend certification. There is no standard, publicly available way for patients to compare them. The BARIC Score fills that gap.

BARIC stands for the five criteria that matter most when choosing a hyperbaric oxygen therapy provider:

• Board-certified medical oversight
• ATA range
• Real informed consent
• Indication match
• Cost transparency

The scoring criteria are grounded in UHMS accreditation standards, FDA guidance on hyperbaric oxygen therapy, and published clinical evidence.

How the Scoring Works

Each criterion is scored on a 0-1-2 scale. The total BARIC Score ranges from 0 to 10.

B – Board-Certified Medical Oversight (0-2 points)

Score	What It Means
2	Named medical director with UHMS PATH certification or board certification in undersea and hyperbaric medicine. Staff includes CHT or CHRN credentialed technicians.
1	Physician medical director with relevant training but not board-certified in hyperbaric medicine. Technicians have basic training.
0	No physician medical director, or medical director has no hyperbaric-specific training. Technicians lack recognized credentials.

Why it matters: HBOT involves breathing 100% oxygen at elevated pressures. Complications include barotrauma, oxygen toxicity seizures, and in rare cases pulmonary edema. The UHMS requires physician oversight as part of its facility accreditation standards. A facility without qualified medical oversight cannot manage these emergencies safely. In multiple documented fraud cases, clinics billed for physician-supervised care when no qualified physician was involved.

A – ATA Range (0-2 points)

Score	What It Means
2	Hard chamber capable of reaching 2.0+ ATA (atmospheres absolute) with 100% medical-grade oxygen. Can deliver evidence-based protocols for the patient’s specific indication.
1	Hard chamber with limited range (1.3-1.5 ATA only) or hard chamber that does not offer protocols matched to the patient’s condition.
0	Soft chamber only (1.3 ATA max, ambient air with concentrator). Cannot deliver clinical-grade HBOT.

Why it matters: At 2.0 ATA with 100% oxygen, arterial oxygen reaches approximately 1,800 mmHg. At 1.3 ATA with ambient air (soft chamber), it reaches approximately 230 mmHg. The major clinical trials on HBOT for long COVID, TBI, and aging all used 1.5 to 2.0 ATA in hard chambers. A clinic offering soft chamber treatment for these conditions is not delivering the same therapy that produced those research outcomes.

R – Real Informed Consent (0-2 points)

Score	What It Means
2	Clinic proactively discusses side effects, contraindications, and realistic outcomes before treatment begins. Written informed consent covers risks. Honest about evidence limitations for off-label conditions.
1	Clinic provides basic informed consent but downplays risks or overemphasizes benefits. Limited discussion of evidence quality for off-label uses.
0	No meaningful informed consent process. Side effects dismissed as “it’s completely safe.” Cure claims for conditions with weak or no evidence.

Why it matters: The FDA has issued warnings about clinics making unproven claims about HBOT for conditions like autism, cancer, and Alzheimer’s. The UHMS publishes clinical practice guidelines that include contraindication criteria any legitimate program must follow. A clinic that only discusses benefits during the consultation and dismisses side effects is not practicing informed consent. The most common side effect, middle ear barotrauma, is manageable but should be discussed before you’re inside a pressurized chamber.

I – Indication Match (0-2 points)

Score	What It Means
2	Clinic has documented protocols for the patient’s specific condition, can cite the supporting studies, and explains expected session count, ATA pressure, and realistic outcomes.
1	Clinic treats the patient’s condition but uses a generic protocol. Limited ability to discuss evidence or expected outcomes specifically.
0	Clinic applies the same protocol to every patient regardless of condition, or treats conditions with no supporting evidence.

Why it matters: Different conditions require different protocols. Long COVID research used 40 sessions at 2.0 ATA. TBI research used 40 sessions at 1.5 ATA. UHMS-recognized wound care protocols use 2.0-2.4 ATA for 30-60 sessions. A clinic that puts every patient through the same 20-session “wellness protocol” regardless of their condition is not matching the evidence. For a detailed comparison of major HBOT protocols, see our Efrati vs Harch protocol comparison.

C – Cost Transparency (0-2 points)

Score	What It Means
2	Per-session pricing published or provided upfront. Package options available without high-pressure sales. Total protocol cost estimated before commitment. Insurance guidance provided where applicable.
1	Pricing available only after consultation. Some package pressure but per-session option exists.
0	No pricing until after a sales consultation. Aggressive package selling. No per-session option. Dramatic discounts for prepaying 40+ sessions upfront.

Why it matters: A typical HBOT protocol costs $3,000 to $24,000 out of pocket. This is a significant financial commitment. Clinics that hide pricing behind a consultation are often using the consultation as a sales pitch. The best clinics publish pricing because they don’t need high-pressure tactics to fill their chambers.

BARIC Score Interpretation

Score Range	Rating	Recommendation
9-10	Excellent	Top-tier clinic. Book with confidence.
7-8	Good	Solid clinic with minor gaps. Acceptable for most patients.
5-6	Fair	Proceed with caution. Investigate the criteria where points were lost.
3-4	Poor	Significant concerns. Consider alternatives.
0-2	Avoid	Multiple red flags. Do not proceed.

How to Use the BARIC Score

Before your first consultation at any HBOT clinic, score them on each criterion based on publicly available information (website, phone call, reviews). Then update your score after the consultation based on the answers you receive. Compare clinics side by side.

Step 1: Search for UHMS accreditation status on the UHMS directory.

Step 2: Check the clinic’s website for chamber specifications (hard vs soft, ATA capability).

Step 3: Call the clinic and ask the 10 questions from our vetting guide.

Step 4: Score each criterion 0-2 based on their answers.

Step 5: Compare your top 2-3 clinics by total BARIC Score.

Frequently Asked Questions

Who created the BARIC Score?

The BARIC Score was developed by BaricBoost.com, the independent buyer’s guide to hyperbaric oxygen therapy. It is based on UHMS accreditation standards, FDA guidance on hyperbaric oxygen therapy, published clinical evidence, and patient-reported red flags from HBOT buyer communities.

Can a soft chamber clinic score well?

A soft chamber clinic can score up to 1 on ATA Range (if they are transparent about the limitations of 1.3 ATA) and up to 2 on every other criterion. The maximum possible score for a soft-chamber-only clinic is 9/10, but only if they are transparent about what soft chamber HBOT can and cannot do, have proper medical oversight, and do not claim equivalence with hard chamber clinical results.

Does a high BARIC Score guarantee good outcomes?

No. The BARIC Score evaluates clinic quality, not treatment effectiveness for your specific condition. A 10/10 clinic cannot guarantee results for a condition where the underlying evidence is limited. What a high BARIC Score does guarantee is that the clinic is medically supervised, appropriately equipped, transparent, and practicing evidence-based medicine.

Will BaricBoost publish BARIC Scores for individual clinics?

We are working on a public scorecard for the top 50 US HBOT clinics by metro area. In the meantime, use the framework above to score clinics yourself.

Sources

• Undersea and Hyperbaric Medical Society. “UHMS Hyperbaric Facility Accreditation Program.” uhms.org
• FDA. “Hyperbaric Oxygen Therapy: Unproven Claims Include Treating Diabetes and Autism.” fda.gov
• National Board of Diving and Hyperbaric Medical Technology. “CHT/CHRN Certification.” nbdhmt.org
• Zilberman-Itskovich S, et al. “Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition.” Scientific Reports, 2022.
• Harch PG. “Systematic Review and Dosage Analysis: HBOT Efficacy in Mild TBI.” Frontiers in Neurology, 2022.