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Yes, Medicare and most major private insurers cover hyperbaric oxygen therapy for 15 specific medical conditions. For covered indications, patients typically pay 20% of the Medicare-approved amount after the annual Part B deductible of $257 (2025). Off-label uses including TBI, autism, anti-aging, and sports recovery are not covered by any major US insurer.12
15 Medicare-Covered HBOT Conditions (NCD 20.29)
Medicare-covered HBOT conditions (NCD 20.29)
Patient co-pay after $257 Part B deductible
Patient cost per session with Medicare coverage
Medicare facility fee per 30-min segment (G0277)
Medicare Part B covers HBOT when administered in a full-body chamber for these conditions:12
- Acute carbon monoxide intoxication
- Decompression illness
- Gas embolism
- Gas gangrene
- Acute traumatic peripheral ischemia
- Crush injuries and suturing of severed limbs
- Progressive necrotizing infections (necrotizing fasciitis)
- Acute peripheral arterial insufficiency
- Preparation and preservation of compromised skin grafts
- Chronic refractory osteomyelitis (unresponsive to conventional treatment)
- Osteoradionecrosis (as adjunct to conventional treatment)
- Soft tissue radionecrosis (as adjunct to conventional treatment)
- Cyanide poisoning
- Actinomycosis (only as adjunct when refractory to antibiotics and surgery)
- Diabetic wounds of the lower extremities (must be Type 1 or Type 2 diabetes with a Wagner grade III+ wound that has failed standard wound therapy)
Medicare Part B covers hyperbaric oxygen therapy for 15 specific conditions, with patients paying 20% of the approved amount after meeting the $257 annual deductible.”
CMS National Coverage Determination 20.29, verified March 2026
What Is NOT Covered
These uses are not covered by Medicare or most private insurers, despite growing clinical interest:
| Condition | Medicare | Most Private Insurers | Reason |
|---|---|---|---|
| TBI / concussion | Not covered | Not covered | No RCT evidence sufficient for coverage |
| Stroke (acute or chronic) | Not covered | Not covered | No proven benefit in RCTs |
| Sports recovery | Not covered | Not covered | Considered wellness, not medical treatment |
| Anti-aging / wellness | Not covered | Not covered | Considered wellness |
| Long COVID | Not covered | Not covered | No CMS decision as of 2026 |
| Autism spectrum disorder | Not covered | Not covered | Insufficient clinical evidence |
| Fibromyalgia | Not covered | Not covered | Considered investigational |
| Cerebral palsy | Not covered | Not covered | Considered investigational |
Patient Out-of-Pocket Costs with Medicare (2025)
| Scenario | Total Billed | Medicare Pays (80%) | Patient Pays (20%) |
|---|---|---|---|
| Single session | ~$596 | ~$477 | ~$119 |
| 20 sessions | ~$11,917 | ~$9,534 | ~$2,383 |
| 40 sessions | ~$23,834 | ~$19,067 | ~$4,767 |
| + Part B deductible | +$257 (once/year) |
For diabetic foot ulcers, Medicare requires the wound to be Wagner grade III or higher AND that standard wound therapy has already failed before approving HBOT coverage.”
CMS NCD 20.29 / Medicare.gov
HBOT Billing Codes
Understanding the billing codes helps you verify what is being charged and catch errors on your EOB (Explanation of Benefits):4
| Code | Description | Who Bills | 2025 Rate |
|---|---|---|---|
| CPT 99183 | Physician supervision, per session | Physician | ~$108-$137 |
| G0277 | Hyperbaric oxygen, per 30-min segment | Facility | $137.90 |
| Revenue Code 0940 | HBO therapy (hospital outpatient) | Hospital | Varies |
For a complete explanation of HBOT billing codes, see our CPT codes and billing guide.
Private Insurance Coverage
Most private insurers follow Medicare’s 15-condition coverage criteria. UnitedHealthcare, Aetna, Cigna, and Blue Cross plans generally cover HBOT for the same indications. Off-label or wellness uses are almost universally denied. Prior authorization is typically required, and some insurers require documentation of failed standard therapy before approving HBOT for wound care indications.5
How to Get Prior Authorization
- Confirm coverage criteria: Get the exact ICD-10 diagnosis codes and coverage policy from your insurer before starting treatment
- Document medical necessity: Your physician needs records showing wound measurements, Wagner grade, prior treatment history, and clinical rationale
- Submit auth request early: Authorization can take 1-4 weeks. Start treatment before authorization is secured at your own financial risk
- Get session limits in writing: Confirm the number of approved sessions before starting
- Track renewal requirements: Many plans require interim progress documentation for session extensions beyond 30
Medicaid and Tricare
Medicaid coverage varies by state. Some state Medicaid programs cover HBOT for the same conditions as Medicare; others have more restrictive policies or require prior approval through a different process. Tricare (military) generally follows Medicare coverage criteria for HBOT.
If Your Claim Is Denied
Many HBOT claim denials result from documentation gaps rather than blanket coverage exclusions. A denial is appealable. Consult your provider’s billing staff, submit additional medical records supporting necessity, and reference the specific NCD or LCD your plan uses. For formal appeals, your state insurance commissioner is a resource if the insurer is unresponsive.
- Medicare.gov. “Hyperbaric Oxygen Therapy Coverage.” medicare.gov/coverage/hyperbaric-oxygen-therapy. Verified March 2026.
- CMS. “NCD – Hyperbaric Oxygen Therapy (20.29).” cms.gov. Verified May 2026.
- Gelly HB, Fife CE, Walker D, Eckert KA. “Trends in Medicare Costs of Hyperbaric Oxygen Therapy, 2013 through 2022.” Undersea & Hyperbaric Medicine. 2024. DOI: 10.22462/702. PMID: 38985150.
- UHMS. “2025 CMS Payment Update Highlights.” uhms.org. 2025.
- UnitedHealthcare. “Hyperbaric Oxygen Therapy and Topical Oxygen Therapy” medical policy. uhcprovider.com. Verified May 2026.
- PayerPrice. “CPT Code 99183 – Description and Fee Schedule 2026.” payerprice.com. Verified April 2026.
- Schaum KD. “Are You Prepared for Medicare’s Non-emergent Hyperbaric Oxygen Therapy Prior Authorization Model?” Advances in Skin & Wound Care. 2016. PMID: 27538106.
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.
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