10 Questions to Ask Before Starting Hyperbaric Oxygen Therapy

You’ve talked to your doctor and you’re ready to find a facility. Not all HBOT clinics are the same. Asking the right questions upfront can save you money, time, and a poor treatment outcome.

Questions About the Facility and Equipment

1. Is this a medical-grade hyperbaric chamber (2.0 ATA or higher)?

This matters more than it sounds. Medical HBOT runs at 2.0 to 3.0 ATA — the pressure levels where clinical studies show results. Wellness chambers at 1.3 ATA are not FDA-approved for any medical condition. If you’re treating a diagnosed condition, a wellness chamber won’t do what you need.

2. Is there a board-certified or credentialed hyperbaric physician on staff?

Ask who the supervising physician is and what their hyperbaric medicine training includes. Certified Hyperbaric Technologists (CHTs) are trained staff who operate chambers, but a physician needs to be directing your medical care. Some facilities have a physician available by phone, not on-site. For complex medical conditions, on-site physician involvement is worth asking about specifically.

3. Is the facility UHMS-accredited?

UHMS stands for Undersea and Hyperbaric Medical Society. Their accreditation program evaluates facilities against defined standards for safety, equipment, and physician involvement. It isn’t required to operate, so not every good facility has it. But it’s a useful signal. You can search the UHMS directory at uhms.org.

Questions About Your Treatment Plan

4. Is my specific condition FDA-approved for HBOT?

The FDA has approved HBOT for 14 conditions. If yours is on the list, say so and ask the facility to confirm they’re treating it as an approved indication. If your condition is off-label or investigational, the facility should tell you that clearly, including the fact that insurance won’t cover it.

5. How many sessions will my treatment protocol require?

Get a specific number or range, not a vague estimate. Diabetic foot ulcers typically take 20 to 40 sessions. Carbon monoxide poisoning may take 3 to 5. Ask how the protocol is determined and whether it follows published clinical guidelines.

6. How will we measure whether treatment is working?

A good facility tracks progress. For wound conditions, that means regular wound measurements. Ask what the specific checkpoints are and what improvement looks like at each stage.

7. What happens if my condition doesn’t respond?

This is a question most patients don’t think to ask. A straightforward facility will tell you at what point they’d recommend stopping treatment and what alternatives might exist. If they can’t answer this, that’s worth noting.

Questions About Cost and Insurance

8. Will you handle prior authorization with my insurance?

For Medicare and most private insurers, prior authorization is required before HBOT starts. The facility’s billing team should handle this. Ask if they have experience with your specific insurer and whether they’ve gotten prior authorization for your condition before.

9. What is the out-of-pocket cost per session if insurance doesn’t cover it?

Get the cash-pay rate in writing. HBOT sessions at medical-grade facilities typically run $250 to $450 per session without insurance. If a facility won’t give you a clear number, that’s a problem. See the cost guide for a full breakdown of what to expect.

10. Do you offer payment plans or financial assistance?

Many hospital-affiliated hyperbaric programs have financial assistance options, especially for Medicare patients who can’t cover the 20% coinsurance. Ask before you assume you can’t afford it.

Red Flags to Watch For

Some clinics, especially freestanding wellness centers, operate in ways that should make you pause.

Walk away if a facility promises a cure or guarantees specific outcomes. No ethical medical provider does this.

Be cautious if staff can’t tell you who the supervising physician is or what their credentials include. That information should be easy to find and share.

Don’t commit to large session packages before you’ve had even one treatment. Paying for 40 sessions upfront before you know how you’ll respond puts all the financial risk on you.

If a facility claims HBOT treats conditions like TBI, Long COVID, or autism without clearly labeling them as investigational and noting insurance won’t cover them, that’s a compliance issue worth noting.

And if they’re unwilling to work with your insurance for a condition that should be covered, find out why. Legitimate medical facilities bill insurance as a standard part of their operation.

For more on what the first treatment is actually like, read the first session guide. If you’re still sorting out insurance coverage, the insurance guide and Medicare coverage guide cover the details.

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.