Does Medicare Pay for Hyperbaric Oxygen Therapy?

Medicare does pay for hyperbaric oxygen therapy, but only when it is used to treat one of the specific conditions on Medicare’s approved list and delivered inside a pressurized chamber at a qualifying facility. Coverage falls under Part B on an outpatient basis. After you meet the 2026 Part B deductible of $283, you pay 20% of the Medicare-approved amount for each session.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles

Which Conditions Medicare Covers

National coverage determination 20.29 sets the list. If your diagnosis is on it and your provider documents medical necessity, Medicare will generally pay:

  • Acute carbon monoxide intoxication
  • Decompression illness
  • Gas embolism
  • Gas gangrene
  • Acute traumatic peripheral ischemia, where loss of the limb or its function is threatened
  • Crush injuries and reattachment of severed limbs, when function or the limb itself is at risk
  • Progressive necrotizing infections, such as necrotizing fasciitis
  • Acute peripheral arterial insufficiency
  • Compromised skin grafts, to preserve a failing graft (not as the primary wound treatment)
  • Chronic refractory osteomyelitis that has not responded to standard care
  • Osteoradionecrosis and soft tissue radionecrosis, as a supplement to conventional treatment
  • Cyanide poisoning
  • Actinomycosis that has not responded to antibiotics and surgery
  • Diabetic wounds of the lower extremities, under stricter criteria described below

If your condition is not on this list, Medicare will not pay for the therapy, regardless of what a provider recommends.2Medicare.gov. Hyperbaric Oxygen Therapy

Diabetic Foot Wounds Have Extra Rules

Diabetic lower-extremity wounds are covered, but only when three conditions are all met:

  • You have Type 1 or Type 2 diabetes with a lower-extremity wound caused by the disease.
  • The wound is Wagner grade III or higher, meaning it extends into deeper tissue or bone, or involves an abscess or gangrene.
  • Standard wound therapy has been tried for at least 30 consecutive days with no measurable signs of healing.

Once treatment begins, your wound must be evaluated at least every 30 days. If it shows no measurable improvement during any 30-day period, Medicare stops paying. HBOT also has to continue alongside standard wound care, not replace it.3Centers for Medicare & Medicaid Services. National Coverage Determination – Hyperbaric Oxygen Therapy

This is where many diabetic-wound claims fall apart. If the record doesn’t clearly show 30 days of failed standard treatment before HBOT started, or if the follow-up wound measurements aren’t there, Medicare can deny the claim after the fact. Ask your wound care team to document measurements at every visit.

What Medicare Will Not Pay For

Medicare explicitly excludes hyperbaric oxygen for a long list of conditions. Among the ones patients most often ask about:

  • Pressure ulcers (bedsores) and ulcers from poor circulation or venous insufficiency
  • Thermal burns
  • Stroke and other cerebral vascular insufficiency
  • Multiple sclerosis
  • Alzheimer’s disease and other non-vascular causes of chronic brain syndrome
  • Heart attack and cardiogenic shock
  • Sickle cell anemia
  • Pulmonary emphysema
  • Arthritis
  • Organ transplantation or organ storage

The full exclusion list runs to 22 conditions.3Centers for Medicare & Medicaid Services. National Coverage Determination – Hyperbaric Oxygen Therapy You may see clinics marketing HBOT for autism, traumatic brain injury, post-concussion syndrome, or anti-aging. None of those are Medicare-covered uses, and you would owe the full cost.

One narrow point worth flagging: topical oxygen applied directly to a wound surface is not the same as HBOT under Medicare’s definition. Coverage for topical oxygen is handled separately by your regional Medicare Administrative Contractor, not by the national HBOT policy.

Where Treatment Has To Happen

Medicare only pays when the therapy is delivered inside a pressurized chamber, either a multiplace chamber that treats several patients at once or a monoplace unit for one person. The site has to be a hospital outpatient department, a physician’s office, or a freestanding clinic that meets Medicare’s conditions of participation. A physician must prescribe the therapy and document why it is medically necessary for your case.3Centers for Medicare & Medicaid Services. National Coverage Determination – Hyperbaric Oxygen Therapy

Portable, inflatable “mild” hyperbaric chambers marketed for home use do not qualify. They operate at much lower pressures than clinical chambers, and Medicare will not reimburse their purchase or rental.

What You Actually Pay

Under Original Medicare, HBOT is a Part B outpatient service. You pay the annual Part B deductible ($283 in 2026), then 20% coinsurance on the Medicare-approved amount for each session. HBOT courses often run to dozens of sessions over several weeks, so the coinsurance adds up quickly. A Medigap policy can cover some or all of that 20%, depending on the plan you have.

If you receive HBOT as a hospital inpatient rather than an outpatient, coverage shifts to Part A, and you owe the inpatient deductible and any applicable copays instead.

Before starting treatment, confirm that your provider accepts Medicare assignment. A provider who accepts assignment agrees to charge no more than the Medicare-approved amount; one who doesn’t can bill you more.

Medicare Advantage plans have to cover HBOT for the same conditions Original Medicare covers, but the cost-sharing often looks different.4Medicare.gov. Compare Original Medicare and Medicare Advantage Your plan may charge a flat copay per session, restrict you to in-network facilities, or require prior authorization. Call your plan before scheduling.

Get The ABN In Writing

If a provider thinks Medicare might not cover the HBOT they are recommending, they have to give you an Advance Beneficiary Notice before treatment starts. The ABN tells you in writing that Medicare might deny the claim and that you could owe the full amount. You then decide whether to proceed and take on that risk, or decline.5Centers for Medicare & Medicaid Services. Form Instructions – Advance Beneficiary Notice of Non-coverage

If a provider skips the ABN and Medicare later denies the claim, the provider generally cannot bill you. Read the form before you sign. Signing means you have agreed to pay out of pocket if the claim is rejected.

If Medicare Denies Your Claim

You have the right to appeal, and the appeals process runs through five independent levels. The first level is a redetermination by the Medicare Administrative Contractor that processed your claim; you file in writing by the deadline printed on your Medicare Summary Notice. If that is upheld, you have 180 days to ask for reconsideration by a Qualified Independent Contractor. Further levels lead to an Administrative Law Judge hearing, the Medicare Appeals Council, and ultimately federal court.6Medicare.gov. Appeals in Original Medicare

Most HBOT denials that get overturned are won at the first or second level, and usually because the original claim was missing documentation rather than because the treatment itself wasn’t covered. Before filing, pull your records together: the diagnosis, the treatments already tried, wound measurements over time, and the physician’s medical-necessity notes. Gaps in that record are the single most common reason claims get denied and the single most fixable reason on appeal.7HHS.gov. The Appeals Process

If you get stuck, call 1-800-MEDICARE (1-800-633-4227) and ask for the Medicare Beneficiary Ombudsman, who handles complaints and can help you understand your rights at each stage of the appeal.8Medicare.gov. Get Help With Your Rights and Protections