US Clinical HBOT Patient Volume
No single database tracks all HBOT treatments in the United States. Piecing together Medicare claims, wound care center networks, freestanding clinic reports, and military/VA records, the best estimate is that several hundred thousand HBOT treatment courses are administered annually. Here is what each data source shows.
The most reliable anchored figure comes from Medicare and the US Wound Registry. Medicare HBOT treatments peaked at 31,389 in 2021, with an average of 26.3 sessions (SD 6.8) per patient.1
Medicare Utilization Data
| Year | Medicare HBOT Treatments | Facility Cost (40 sessions) |
|---|---|---|
| 2013 | 19,400 | $21,569 |
| 2021 (peak) | 31,389 | N/A |
| 2022 | 25,916 | $19,488 |
Medicare facility costs decreased 10.7% from 2013 to 2022, reflecting both pricing pressure and efficiency improvements in wound care delivery.1
US Wound Registry Data
The US Wound Registry (USWR) provides the most comprehensive real-world dataset on HBOT utilization in clinical wound care.2
- Total patients captured (2012-2018): 199,158 patients across 2,100 providers
- Patients receiving HBOT: 3,697 of registry participants
- DFU patients receiving HBOT: 9,908 of 62,843 diabetic foot ulcer patients (15.7%)
- Average treatments per DFU patient: 28 sessions
“The US Wound Registry captured 199,158 patients across 2,100 providers between 2012 and 2018, with diabetic foot ulcer patients receiving hyperbaric oxygen therapy averaging 28 treatment sessions per patient.”
Fife & Eckert 2018, Undersea & Hyperbaric Medicine
Patient Volume by Setting
| Setting | Est. Annual Patients | Avg Sessions/Patient | Primary Conditions |
|---|---|---|---|
| Hospital wound care | 70,000-90,000 | 30-40 | Diabetic ulcers, radiation injury |
| Freestanding clinics | 30,000-40,000 | 20-40 | Long COVID, TBI, anti-aging |
| Military/VA | 5,000-8,000 | 40-60 | TBI/blast injury, wound care |
| Emergency/acute | 3,000-5,000 | 1-5 | CO poisoning, decompression sickness |
Off-Label and Cash-Pay Patients
The fastest-growing patient segment is individuals paying out of pocket for off-label HBOT. Based on clinic surveys and industry estimates, off-label patients represent approximately 20-30% of freestanding clinic volume and nearly 100% of home chamber usage.
Long COVID surged as an off-label driver after the Tel Aviv RCT (Zilberman-Itskovich et al. 2022) demonstrated significant improvements in cognitive function and brain perfusion.3 Many freestanding clinics report long COVID as their fastest-growing patient category since 2022.
Global Patient Volume
Globally, an estimated 500,000-700,000 patients receive clinical HBOT annually. The United States accounts for roughly 25-30% of global total, followed by China, Japan, Israel, Germany, and the United Kingdom. Israel has the highest per-capita HBOT utilization rate globally, driven by national insurance coverage for several off-label indications.
“Medicare HBOT treatment volume peaked at 31,389 sessions in 2021, while the facility cost per 40-session course decreased 10.7% from $21,569 in 2013 to $19,488 in 2022, demonstrating both growing utilization and improving cost efficiency.”
UHMS Journal 2024, Medicare claims analysis
Patient Demographics
- Hospital wound care: Predominantly 60+, male-skewing (reflecting diabetes demographics), Medicare-insured
- Freestanding clinics: Broader age range (35-65), roughly equal gender split, higher income (cash-pay)
- Home chamber users: Skew 30-55, male-leaning, health-optimization oriented
- Military/VA: Predominantly male, 25-50
- UHMS Journal. (2024). Trends in Medicare Costs of HBO2 Therapy, 2013-2022. Undersea & Hyperbaric Medicine. uhms.org
- Fife C, Eckert K. (2018). The Hyperbaric Oxygen Therapy Registry. Undersea & Hyperbaric Medicine. DOI: 10.22462/01.02.2018.1
- Zilberman-Itskovich S et al. (2022). HBOT improves neurocognitive functions and symptoms of post-COVID condition. Scientific Reports. 12:11252. DOI: 10.1038/s41598-022-15565-0
- CMS. Medicare Part B Claims Data: CPT 99183. Annual claims analysis. cms.gov
- Healogics. Annual Wound Care Report. Company publication.
- UHMS. Hyperbaric Oxygen Therapy: Indications, 14th Edition. 2024. uhms.org
- Divers Alert Network (DAN). Annual Diving Report: Decompression Illness Cases. 2024.
- Tanaka H et al. (2023). Emerging indications for HBO treatment: Registry cohort study. Interactive Journal of Medical Research. DOI: 10.2196/53821
- Wound Care Advantage. HBOT Utilization Trends in Hospital-Based Wound Care. Industry report.
Trend Over Time: Medicare HBOT Utilization
Medicare claims data provides the only longitudinal tracking of HBOT patient volume in the US. The trend shows steady growth through the 2010s, a peak around 2021, and a slight pullback:
- 2013: 19,400 Medicare HBOT treatments. Facility cost for a 40-session course: $21,569.
- 2017-2019: Gradual increase to an estimated 24,000 to 27,000 treatments annually, driven by expanded wound care center networks and growing recognition of HBOT for radiation injury.
- 2021: Peak at 31,389 treatments, a 62% increase over 2013. The spike reflects both underlying growth and a post-COVID catch-up effect as elective wound care treatments resumed after 2020 deferrals.
- 2022: Slight pullback to 25,916 treatments, with facility costs down to $19,488 per 40-session course (a 10.7% decrease from 2013).
The cost decrease over time reflects both Medicare reimbursement pressure and wound care delivery efficiency gains. More treatments per chamber per day, driven by protocol standardization, reduced per-treatment facility costs.
Comparison to Other Countries
The US treats an estimated 100,000 to 150,000 HBOT patients annually across all settings. How does this compare globally?
- China: As of 2020, 1,924 institutions with 11,266 HBOT practitioners treated an estimated 200,000+ patients annually. China has nearly twice the US chamber count and a substantially larger patient volume, driven partly by government health policy favoring HBOT for stroke rehabilitation.
- Israel: With 15 to 20 chambers per million residents (the world’s highest density), Israel treats an estimated 10,000 to 15,000 patients annually. Israel’s Shamir Medical Center runs the largest single-site multiplace HBOT program in the world and has produced much of the clinical trial data on HBOT for long COVID, TBI, and aging.
- United Kingdom: Approximately 3 to 4 chambers per million, treating an estimated 5,000 to 8,000 patients annually. The NHS covers HBOT only for decompression illness and gas embolism. Multiple sclerosis charities operate the majority of UK HBOT facilities.
- Japan: An estimated 15,000 to 20,000 patients annually, with strong adoption in sports medicine (professional baseball and soccer teams maintain chambers) and post-stroke rehabilitation.
The US accounts for roughly 25 to 30% of global clinical HBOT volume. Per-capita treatment rates are lower than Israel but higher than most European countries, reflecting a larger off-label cash-pay market but more restrictive insurance coverage than nations with universal healthcare systems.
Wait Times and Access Implications
Patient volume directly affects access. At hospital-based wound care centers, the average wait time for non-emergency HBOT is 1 to 3 weeks. During peak periods, some programs report 4 to 6 week waits for new patients.
Freestanding clinics typically offer faster access, often within days. Cash-pay patients face no insurance authorization delays, which can add 1 to 2 weeks at hospital programs. For emergency indications (carbon monoxide poisoning, decompression sickness, gas embolism), treatment begins immediately at facilities with 24/7 capability.
The growing patient volume, particularly from off-label demand, is straining capacity at freestanding clinics. Some high-volume clinics report running chambers 10 to 12 hours per day, 6 days per week, to meet demand. This has driven chamber purchases and new clinic openings, particularly in high-demand markets like Florida, Texas, and California.
Medical Disclaimer
The content on BaricBoost.com is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Author
Seph Fontane Pennock is the founder of BaricBoost.com and Regenerated.com, a clinic directory for regenerative medicine serving 10,000+ providers across the United States. He previously built and sold PositivePsychology.com, which grew to 19 million users and became the largest evidence-based positive psychology resource on the web. Seph brings direct experience as an HBOT patient, having completed protocols at clinics across three continents while navigating mold illness, systemic inflammation, and autoimmune conditions. His treatment journey includes hyperbaric oxygen therapy, peptide protocols, NAD+ therapy, and consultations with specialists from Dubai to Cape Town to Mexico. This combination of entrepreneurial track record and lived patient experience shapes everything published on BaricBoost.com. Every article is grounded in peer-reviewed research, informed by real clinical encounters, and written for patients making high-stakes treatment decisions. Seph's focus is on bringing transparency, scientific rigor, and practical guidance to the hyperbaric oxygen therapy space.
