Hyperbaric Chambers: Insurance and Medicare Guide
For patients researching medical-grade hyperbaric oxygen therapy (HBOT), one of the biggest doubts is whether or not hyperbaric chamber therapy is covered by insurance. Whether you're dealing with osteoradionecrosis (ORN), Actinomyces jaw infections, diabetic wounds, sudden hearing loss, or another condition requiring advanced oxygen therapy, understanding insurance and Medicare rules is essential.
At Bay Area Hyperbarics, we help patients navigate both the clinical and financial aspects of treatment. We’ll break down what hyperbaric therapy is, which conditions qualify for coverage, depending on your insurance company,, how Medicare makes decisions, and what you can expect as you prepare for your HBOT sessions.
Are Hyperbaric Chamber Treatments Covered by Insurance?
Insurance coverage for HBOT depends on your diagnosis, medical history, and whether your condition is included in the list of FDA- and Medicare-approved indications. While hyperbaric oxygen therapy has become more widely used, only certain conditions qualify for coverage.
Does Insurance Cover Hyperbaric Treatment?
Most commercial insurance carriers follow Medicare’s lead. Commonly covered conditions include:
- Osteoradionecrosis (ORN): A serious radiation injury where damaged bone loses oxygen supply. HBOT helps restore blood flow and support healing. Learn more on our page for Radiation Damage and Wounds.
- Actinomyces Jaw Infections (Actinomycosis): Chronic infections affecting the jawbone often require combined therapy with antibiotics and HBOT.
- Diabetic Foot Ulcers (Wagner Grade III or higher): One of the most common covered indications. These wounds require improved oxygenation and circulation.
- Chronic Refractory Osteomyelitis: Non-healing bone infections that haven’t responded to standard therapy.
- Compromised Skin Grafts or Flaps: HBOT helps salvage grafts by supplying oxygen to struggling tissue.
- Carbon Monoxide Poisoning: A medical emergency that requires immediate HBOT intervention.
- Sudden Hearing Loss: Hyperbaric Oxygen Therapy (HBOT) for Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL) is often covered by private insurance companies, though Medicare generally does not cover it as yet. HBOT is an FDA-approved therapy for ISSHL. It's considered a medical emergency, and prompt treatment (within days/weeks) with HBOT and steroids significantly improves outcomes.
These conditions are strongly supported by clinical evidence and widely accepted by insurance carriers. If your provider or specialist recommends HBOT as a necessary part of your treatment plan, documentation can significantly influence approval.
Medicare Coverage for Hyperbaric Oxygen Therapy
Medicare is one of the clearest resources for understanding when HBOT is considered medically necessary. If a condition is on Medicare’s National Coverage Determination (NCD) list, most commercial insurance plans follow suit. The only exception is sudden hearing loss, where most private insurance companies cover it, but Medicare does not as yet.
Hyperbaric Oxygen Therapy Medicare Coverage
Medicare covers HBOT for these key conditions, when delivered in a medical-grade, pressurized chamber:
- Osteoradionecrosis (ORN)
- Soft-tissue radionecrosis
- Chronic refractory osteomyelitis
- Diabetic wounds meeting coverage criteria
- Carbon monoxide poisoning
- Gas gangrene
- Crush injuries and acute traumatic ischemia
- Compromised grafts and flaps
What Medicare and Private Insurance Requires
Medicare and private insurance companies typically require:
- Proof of medical necessity: Your medical records must show why HBOT is essential for your condition.
- Documentation of prior treatments: For example, diabetic wound patients must show they’ve attempted standard wound therapy for at least 30 days without improvement. Sudden hearing loss patients must often show that they have attempted steroid treatment without significant improvement.
- Treatment in a qualified facility: HBOT must take place in an approved, pressurized chamber, not a soft-sided or at-home device.
- A supervising physician: Medicare and most insurance companies require that a trained physician is immediately available during treatments, such as at our facility.
Does Medicare Pay for Hyperbaric Oxygen Therapy?
Under Medicare Part B:
- Patients typically pay 20% of the Medicare-approved amount for each HBOT session.
- The annual Part B deductible applies.
- Ongoing therapy requires periodic reassessment to confirm continued benefit.
These rules mean that Medicare beneficiaries who meet the criteria can often access HBOT with predictable costs, as long as the therapy is medically justified.
Preparing for Your HBOT Session
Once your insurance or Medicare coverage is confirmed, your next step is preparing for treatment. At Bay Area Hyperbarics, we walk each patient through the full process so treatments feel comfortable, predictable, and stress-free.
1. Your Initial Consultation
During your consultation, our medical team will:
- Review your diagnosis and medical history
- Confirm that HBOT is appropriate and safe– that you do not have any contraindications that could otherwise make HBOT unsafe.
- Determine the required number of sessions (typically 20–40)
- Provide documentation needed for insurance approval
If you’re treating ORN, Actinomyces infection, diabetic ulcers or sudden hearing loss, we also coordinate with your surgeon, dentist, oncologist, ENT or wound care specialist.
2. What to Expect During Treatment
A typical HBOT session includes:
- Checking vitals and
- Oxygen safety screening
- Entering a comfortable, transparent chamber
- Relaxing as the pressure in the chamber increases
- Breathing 100% oxygen and relaxing for 60–120 minutes
- Slowly returning to normal pressure
Most patients report that treatment feels peaceful and easy—many listen to music, watch a movie, rest, or nap during sessions.
3. After Your Session
You may feel slightly tired or experience temporary ear pressure. These effects usually resolve quickly. Sometimes, you can feel pressure for several hours, but this pressure typically resolves. Healing is gradual, with benefits building over a full course of therapy. Most patients do not notice improvements until after several sessions. During this time, the body is healing from the inside-out, where a great deal of healing happens before a person can see any tangible result.
Support for Confident Treatment Decisions
Understanding how hyperbaric oxygen therapy is covered by insurance, along with Medicare rules, and treatment preparation is the first step toward accessing effective hyperbaric therapy. If you’re exploring HBOT for ORN, Actinomyces infections, chronic wounds, or another medically recognized condition, expert guidance makes all the difference.
Bay Area Hyperbarics has decades of experience helping patients secure insurance-covered HBOT treatments, coordinating Medicare approvals, and providing clinically advanced hyperbaric care. If you’re ready to take the next step, contact us to get personalized support and begin your path to healing.
