How much does Medicare pay for HBOT?

Medicare Part B pays 80% of the approved amount after your Part B deductible. You pay the remaining 20% coinsurance. Medigap plans typically cover that 20%. Medicare reimbursement rates change annually, so verify current cost-sharing with your facility's billing team before starting treatment.

Does Medicare cover HBOT for diabetic foot ulcers?

Yes. Diabetic foot ulcers are one of the most common conditions covered under Medicare's NCD 20.29. Coverage requires that the wound has failed to heal after 30 days of standard wound care. Your physician and the facility's billing team handle the documentation.

Does Medicare cover HBOT for TBI, Long COVID, or stroke recovery?

No. These are off-label, investigational uses of HBOT. Medicare does not cover them under any circumstance. Patients pursuing HBOT for these conditions pay entirely out of pocket at facilities that offer them.

Does Medicare Cover Hyperbaric Oxygen Therapy?

Q: Does Medicare cover hyperbaric oxygen therapy?

Yes. Medicare Part B covers HBOT for 14 approved conditions under National Coverage Determination 20.29. Treatment must be provided at a Medicare-certified hospital outpatient facility. Freestanding wellness clinics and spas are not covered even for approved conditions.

Yes, Medicare does cover HBOT — but only for specific conditions and only at specific types of facilities. If your condition is on the approved list and you’re treated at a Medicare-certified hospital outpatient center, Part B will pay most of the cost.

Which Conditions Medicare Covers

Medicare Part B covers HBOT under National Coverage Determination 20.29. The NCD lists 14 approved conditions:

Diabetic foot ulcers (Wagner Grade III or higher, failing to heal after 30 days of standard care)
Radiation tissue injury (osteoradionecrosis and soft tissue radionecrosis)
Non-healing wounds meeting specific clinical criteria
Decompression sickness
Carbon monoxide poisoning
Gas gangrene (clostridial myonecrosis)
Necrotizing soft tissue infections
Refractory osteomyelitis
Crush injuries and traumatic ischemias
Compromised skin grafts and flaps
Arterial gas embolism
Acute peripheral arterial insufficiency
Sudden sensorineural hearing loss (idiopathic)
Central retinal artery occlusion

Diabetic wounds and radiation injury are by far the most common reasons Medicare patients seek HBOT. If you’re dealing with either of those, read the full condition pages: diabetic wounds and radiation injury.

One requirement that catches people off guard: treatment must happen at a Medicare-certified hospital outpatient facility. Freestanding HBOT clinics and wellness centers don’t qualify, even when treating covered conditions. If the facility isn’t a hospital outpatient department, Medicare won’t pay.

How Medicare Part B Pays

After you meet your Part B deductible, Medicare pays 80% of the approved reimbursement amount. You pay the remaining 20% coinsurance.

Medigap (Medicare Supplement) plans typically cover that 20% coinsurance, though coverage depends on your specific plan. Check your plan documents or call your Medigap insurer directly.

Medicare Advantage (Part C) plans follow Original Medicare’s coverage rules for HBOT, but benefits and cost-sharing vary by plan. Verify the details with your plan before scheduling anything.

Medicare reimbursement rates change annually. Always verify current rates and your specific cost-sharing with the facility’s billing team before starting treatment.

Prior authorization is almost always required. You won’t be handling that yourself. The facility’s billing team works with your referring physician to submit the documentation.

What Medicare Won’t Cover

Medicare doesn’t cover HBOT for off-label or investigational uses. That includes:

Traumatic brain injury (TBI)
Long COVID
Autism spectrum disorder
Anti-aging or athletic recovery
Fibromyalgia
Stroke recovery
Lyme disease
Multiple sclerosis

These uses are investigational. The evidence base doesn’t yet meet the standard required for Medicare coverage, and insurance won’t pay for them under any plan.

Home hyperbaric chambers are also never covered. Not under Part B, not under Medicare Advantage, not under any circumstance.

Even for covered conditions, if you get treatment at a freestanding wellness clinic, Medicare won’t pay. The facility type requirement is strict.

How to Get Prior Authorization

You don’t manage this process yourself. Your referring physician and the hyperbaric facility’s billing team handle prior authorization together.

What they typically need to submit:

A physician order documenting your condition and its severity
Clinical records showing the condition meets Medicare’s specific criteria
For wound conditions: documentation that the wound has failed to improve after 30 days of standard wound care

For diabetic foot ulcers specifically, that 30-day standard care requirement is important. Medicare wants to see that conservative wound management was tried first. Your wound care provider should be documenting this as you go, before any HBOT referral is made.

If your physician is referring you to a Medicare-certified hospital outpatient HBOT program, the facility’s team has done this many times before. Let them lead the process. Ask the billing coordinator what they need from you and from your referring physician, and make sure those handoffs happen.

For a full look at how insurance works for HBOT beyond Medicare, see the insurance guide. Questions about out-of-pocket costs? The cost guide has the numbers.

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before pursuing any medical treatment.