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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, which is $283 in 2026 (up from $257 in 2025). Off-label uses including TBI, autism, anti-aging, and sports recovery are not covered by any major US insurer.[1][2][9]
Which Conditions Does Medicare Cover for HBOT?
Medicare-covered HBOT conditions (NCD 20.29)
Patient coinsurance after the $283 Part B deductible (2026)
Patient cost per session with Medicare coverage (2022 claims data)
Medicare facility fee per 30-min segment (G0277, CY 2025)
Medicare Part B covers HBOT when administered in a full-body chamber (including one-person units) for the 15 conditions in National Coverage Determination 20.29. The table lists each condition with its key coverage criterion and an example diagnosis code; your provider’s Medicare contractor publishes the exact accepted code list.[1][2]
The 15 Medicare-Covered HBOT Conditions (NCD 20.29)
| Condition | Key Coverage Criterion | ICD-10 Example |
|---|---|---|
| 1. Acute carbon monoxide intoxication | Acute poisoning event | T58.91XA |
| 2. Decompression illness | Diving or pressure-change injury | T70.3XXA |
| 3. Gas embolism | Air or gas in the vascular system | T79.0XXA |
| 4. Gas gangrene | Clostridial infection | A48.0 |
| 5. Acute traumatic peripheral ischemia | Adjunct when loss of function, limb, or life is threatened | T79.A0XA |
| 6. Crush injuries and suturing of severed limbs | Adjunct when loss of function, limb, or life is threatened | S97.80XA |
| 7. Progressive necrotizing infections | Necrotizing fasciitis | M72.6 |
| 8. Acute peripheral arterial insufficiency | Acute arterial blockage | I74.3 |
| 9. Compromised skin grafts | Preparation and preservation; not primary wound management | T86.821 |
| 10. Chronic refractory osteomyelitis | Unresponsive to conventional medical and surgical management | M86 (series) |
| 11. Osteoradionecrosis | Adjunct to conventional treatment | M27.2 |
| 12. Soft tissue radionecrosis | Adjunct to conventional treatment | L59.8 |
| 13. Cyanide poisoning | Acute poisoning event | T65.0X1A |
| 14. Actinomycosis | Refractory to antibiotics and surgical treatment | A42.9 |
| 15. Diabetic wounds of the lower extremities | Type 1 or 2 diabetes, Wagner grade III+, failed 30+ days of standard wound therapy | E11.621 + wound site code |
For diabetic foot ulcers, two conditions must both hold before Medicare approves coverage: the wound must be Wagner grade III or higher, and an adequate course of standard wound therapy must have failed, defined as no measurable signs of healing for at least 30 consecutive days. Coverage also stops if no measurable healing occurs within any 30-day period during HBOT.[1]
What Is NOT Covered
These uses are not covered by Medicare or most private insurers, despite growing clinical interest. Off-label patients pay the full amount themselves, and our hyperbaric chamber cost guide breaks down typical session and package prices:
| 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 |
Patients paying out of pocket for a non-covered indication sometimes weigh a home unit against clinic packages; our hyperbaric chamber rental guide covers what self-pay monthly access actually costs.
What Does HBOT Cost Out of Pocket with Medicare?
| 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 | +$283 (once/year, 2026) |
These figures use average 2022 Medicare claims data from Gelly et al. (2024), who found the total Medicare cost per 40-session course fell 15.6% from 2013 to 2022, to $23,834.[3] Medigap supplemental plans typically pick up the 20% coinsurance; Medicare Advantage plans set their own copays, so the per-session amount varies by plan. Whether those dollars buy outcomes is a separate question; our HBOT cost-effectiveness data page covers the value evidence by indication.
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 | Medicare Rate |
|---|---|---|---|
| CPT 99183 | Physician supervision, per session | Physician | ~$109 average (2022 claims data) |
| G0277 | Hyperbaric oxygen, per 30-min segment | Facility | $137.90 (CY 2025) |
| Revenue Code 0940 | HBO therapy (hospital outpatient) | Hospital | Varies |
For a complete explanation of HBOT billing codes, see our CPT codes and billing guide.
Does Private Insurance Cover Hyperbaric Oxygen Therapy?
Yes, for roughly the same condition list. The major carriers publish HBOT coverage policies that track NCD 20.29 closely, with carrier-specific additions and documentation rules:
- UnitedHealthcare maintains a combined hyperbaric and topical oxygen therapy medical policy that covers systemic HBOT for UHMS-recognized indications and excludes topical oxygen as unproven.[5]
- Aetna covers HBOT under Clinical Policy Bulletin 0172, which lists covered indications and classifies uses such as topical HBOT and limb-encasing devices as experimental.[6]
- Cigna covers systemic HBOT under Medical Coverage Policy 0053 (Hyperbaric Oxygen Therapy, Systemic & Topical), aligned with UHMS-recognized indications.[7]
Across carriers, three patterns hold: off-label and wellness uses are almost universally denied, prior authorization is typically required for non-emergency treatment, and wound care indications require documented failure of standard therapy first. Blue Cross Blue Shield policies vary by state plan but generally follow the same UHMS-based framework.
How Do You Get Prior Authorization for HBOT?
Traditional Medicare does not currently require prior authorization for HBOT; a CMS demonstration that required it for non-emergent HBOT in three states ended in 2018.[10] Commercial plans and many Medicare Advantage plans do require it. The process:
- 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 the request early: Authorization can take 1-4 weeks. Starting treatment before authorization is secured puts the cost 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. Check your state Medicaid provider manual for its HBOT policy before scheduling. Tricare (military) generally follows Medicare coverage criteria for HBOT, including the Wagner grade III+ requirement for diabetic wounds.
What If Your HBOT Claim Is Denied?
Many HBOT denials result from documentation gaps rather than blanket coverage exclusions, and denials are appealable. For traditional Medicare, the appeals process has five levels: redetermination by your Medicare Administrative Contractor (file within 120 days), reconsideration by a Qualified Independent Contractor (180 days), a hearing before an administrative law judge at the Office of Medicare Hearings and Appeals, review by the Medicare Appeals Council, and finally federal district court.[8]
Practically, most successful HBOT appeals win at the first two levels by fixing the record: submit wound measurements, Wagner grading, the 30-day standard-therapy history, and physician supervision notes, and reference NCD 20.29 or your plan’s specific policy number (UHC’s hyperbaric policy, Aetna CPB 0172, or Cigna 0053) in the appeal letter. For private insurance, follow the plan’s internal appeal process first; if the insurer is unresponsive, your state insurance commissioner can intervene on fully insured plans.
Does insurance cover HBOT for long COVID?
No. Long COVID is not among the 15 conditions in Medicare’s NCD 20.29, and no major private insurer lists it as a covered HBOT indication as of 2026, so treatment is self-pay.[1] Clinical trials are ongoing, and coverage policies get revisited as evidence accumulates. Our HBOT for long COVID cost guide tracks current self-pay pricing and the trial evidence.
Does Medicare cover home hyperbaric chambers?
No. Medicare pays for HBOT only when it is administered in a chamber at a facility under physician supervision for a covered indication; it does not buy or rent home chambers as durable medical equipment.[1][2] Soft-shell home chambers are also FDA-cleared only for acute mountain sickness, which is not a Medicare-covered HBOT indication. Home chamber costs are entirely out of pocket.
How many HBOT sessions will Medicare approve?
NCD 20.29 sets no fixed session cap, but for diabetic wounds Medicare requires evaluation at least every 30 days and ends coverage if no measurable healing occurs in any 30-day treatment period.[1] Typical covered wound protocols run 20 to 40 sessions. Medicare Advantage and commercial plans usually authorize a set number of sessions up front and require progress documentation for extensions.
Sources
- CMS. “National Coverage Determination (NCD) for Hyperbaric Oxygen Therapy (20.29).” Medicare Coverage Database. Link
- Medicare.gov. “Hyperbaric Oxygen Therapy Coverage.” Medicare.gov. Link
- Gelly HB, Fife CE, Walker D, Eckert KA. “Trends in Medicare Costs of Hyperbaric Oxygen Therapy, 2013 through 2022.” Undersea & Hyperbaric Medicine, 51(2):137-144, 2024. DOI: 10.22462/702. PMID: 38985150
- UHMS. “2025 CMS Payment Update Highlights.” Undersea & Hyperbaric Medical Society, 2025. Link
- UnitedHealthcare. “Hyperbaric Oxygen Therapy and Topical Oxygen Therapy” commercial medical policy. UHCprovider.com. Link
- Aetna. “Hyperbaric Oxygen Therapy (HBOT).” Clinical Policy Bulletin 0172. Aetna.com. Link
- Cigna. “Hyperbaric Oxygen Therapy, Systemic & Topical.” Medical Coverage Policy 0053. Cigna.com. Link
- CMS. “Original Medicare (Fee-for-Service) Appeals.” CMS.gov. Link
- Federal Register. “Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rates, and Annual Deductible Beginning January 1, 2026.” November 19, 2025. Link
- CMS. “Evaluation of the Medicare Prior Authorization Model for Non-Emergent Hyperbaric Oxygen Therapy: Final Report.” CMS Innovation Center. Link
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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