Will insurance cover HBOT for cancer survivors?

Insurance may cover HBOT for radiation injury — osteoradionecrosis or soft tissue radionecrosis — when medical criteria are met. It will not cover HBOT as a cancer treatment. Coverage criteria and reimbursement rates change; verify with your facility's billing team.

Can HBOT be used alongside active cancer treatment?

That decision belongs to your oncologist. Some older research raised concerns that HBOT might promote tumor growth via angiogenesis. Newer research has largely addressed those concerns for most tumor types, but oncologists still evaluate this case by case. Never use HBOT during active cancer treatment without oncology approval.

HBOT for Cancer Recovery: Radiation Injury vs. Cancer Treatment

Important: HBOT does not treat cancer. It is FDA-approved for radiation tissue damage — a complication of cancer treatment, not cancer itself. Any use of HBOT to treat active cancer is investigational, unsupported by evidence, and potentially FDA-actionable against providers who make such claims. All costs for non-approved uses are out-of-pocket.

This page covers two different things, and the distinction matters enormously.

HBOT for radiation injury: FDA-approved. Insurance may cover it. Strong evidence. Standard practice at major cancer centers.

HBOT for cancer treatment: not approved. No credible evidence. Potentially dangerous if it delays real cancer care. The FDA has taken enforcement action against providers claiming otherwise.

What HBOT Actually Does for Cancer Survivors

Radiation therapy damages healthy tissue along with tumors. Over time — sometimes years after radiation ends — that damage can show up as osteoradionecrosis, soft tissue radionecrosis, or impaired wound healing.

Osteoradionecrosis is bone death caused by radiation. It most commonly affects the jaw (mandible) in head and neck cancer patients who received radiation to that area. The radiation damages the tiny blood vessels that keep bone tissue alive. Without adequate blood supply, bone dies.

Soft tissue radionecrosis involves the same process in non-bone tissue — muscles, skin, subcutaneous tissue. Radiation-damaged tissue heals poorly after surgery, biopsies, or dental procedures. Blood vessels that were injured by radiation can’t deliver the oxygen that healing requires.

HBOT fixes this by delivering oxygen at pressure. It dramatically increases the amount of oxygen dissolved in plasma, which reaches tissue even where blood vessel damage has compromised normal delivery. It stimulates angiogenesis — the growth of new blood vessels — in the radiated area. Feldmeier et al. (2003) published a comprehensive review of HBOT for radiation injury in cancer survivors, covering the mechanisms and clinical outcomes. PMID: 12964826.

The Marx Protocol — developed by Robert Marx in the 1980s — established the standard approach for using HBOT in osteoradionecrosis, particularly for jaw reconstruction after radiation. Marx et al. (1985) is the foundational paper. PMID: 4017834.

What HBOT Does Not Do

HBOT does not kill cancer cells. It does not reduce tumor size. It does not affect cancer recurrence rates. It does not extend cancer survival. These are not controversial claims — they’re the current state of the evidence.

Any provider, clinic, or website claiming that HBOT “fights cancer,” “treats cancer,” or “helps the body fight cancer” is making an unsupported claim. The FDA has taken enforcement action against HBOT providers for this type of marketing. That’s not theoretical — enforcement actions have been documented.

If you encounter a clinic making these claims, that’s a warning sign about the quality of information that clinic provides generally.

Insurance Coverage for Radiation Injury

Medicare and most private insurers cover HBOT for radiation injury when the patient meets medical criteria. Criteria typically include documented radiation damage, failed conservative treatment, and physician referral.

Coverage is for the FDA-approved indications: osteoradionecrosis and soft tissue radionecrosis. Not for cancer treatment.

Reimbursement rates change annually. Verify current coverage and out-of-pocket costs with your facility’s billing team before starting treatment. Medicare rates for HBOT sessions are typically in the $150-300 range, subject to annual adjustment — confirm current rates with your provider.

A typical radiation injury protocol runs 20-40 sessions, depending on the location and severity of the injury.

The Tumor Growth Concern

Some older research raised a theoretical concern: could HBOT, by stimulating angiogenesis (new blood vessel growth), also help tumors grow? Tumors need blood supply to expand.

This question was taken seriously and studied. More recent research has largely addressed the concern for most tumor types. A review of the literature suggests that HBOT does not promote tumor growth in established cancer patients and may not be contraindicated for patients with solid tumors in many cases.

But oncologists still evaluate this individually. Never use HBOT during active cancer treatment — or in the period following cancer treatment — without your oncologist’s explicit approval. This is a medical decision that requires knowledge of your specific cancer type, treatment history, and current status.

Using HBOT After Cancer Treatment

For cancer survivors experiencing radiation complications, HBOT is a standard, evidence-based option. You’d typically need a referral from your oncologist or primary care physician to a hospital-based hyperbaric program.

Hospital-based programs are generally the right setting for cancer survivors, not freestanding HBOT clinics that may lack the oncology coordination needed for this population.

FAQ

Does HBOT treat cancer? No. It doesn’t kill cancer cells, shrink tumors, or affect survival. Claims to the contrary are unsupported.

What is HBOT FDA-approved for in cancer patients? Radiation injury: osteoradionecrosis and soft tissue radionecrosis. Not cancer itself.

Will insurance cover it? Insurance may cover HBOT for radiation injury when criteria are met. Not as a cancer treatment. Verify rates with your billing team — they change annually.

What is osteoradionecrosis? Bone death caused by radiation, most commonly in the jaw of head and neck cancer patients.

Can HBOT be used during active cancer treatment? Only with explicit oncology approval. This is a case-by-case medical decision.

References

Feldmeier et al. (2003). Hyperbaric oxygen: does it promote growth or recurrence of malignancy? Undersea and Hyperbaric Medicine. PMID: 12964826
Marx et al. (1985). Relationship of oxygen dose to angiogenesis induction in irradiated tissue. PMID: 4017834

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice. HBOT does not treat cancer. For radiation injury, consult your oncologist and a hospital-based hyperbaric medicine program. Individual outcomes vary. This site does not establish a doctor-patient relationship.