Your Medicare Coverage
Is my test, item, or service covered?
Hyperbaric oxygen (HBO) therapy
How often is it covered?
Medicare Part B (Medical Insurance) covers HBO therapy if you have certain conditions. HBO therapy is a process in which your entire body is exposed to oxygen under increased atmospheric pressure. The therapy must be administered in a chamber (including a one-man unit).
Under certain conditions, people with Medicare Part B with these conditions may get HBO:
- Acute carbon monoxide intoxication
- Decompression illness
- Gas embolism
- Gas gangrene
- Acute traumatic peripheral ischemia
- Crush injuries and suturing of severed limbs
- Progressive necrotizing infections
- Acute peripheral arterial insufficiency
- Preparation and preservation of compromised skin grafts
- Chronic refractory osteomyelitis, unresponsive to conventional medical and surgical management
- Osteoradionecrosis as an adjunct to conventional treatment
- Soft tissue radionecrosis as an adjunct to conventional treatment
- Cyanide poisoning
- Actinomycosis, only as an adjunct to conventional therapy when the disease process is refractory to antibiotics and surgical treatment
- Diabetic wounds of the lower extremities if all of these apply:
- You have Type 1 or Type 2 diabetes and have a lower extremity wound that’s due to diabetes.
- You have a wound classified as Wagner grade III or higher.
- You’ve failed an adequate course of standard wound therapy.
You may need to get prior authorization for Medicare to cover your HBO therapy services if these apply:
- You get non-emergency HBO therapy.
- You get the therapy from a facility in Illinois, Michigan, or New Jersey.
You or your facility may send a request for prior authorization to Medicare before you get these services. To do this, you must submit medical records to show that the HBO therapy is medically necessary. A Medicare contractor will review the information. Medicare will cover these services if the contractor decides that the services are medically necessary. For more information, call us at 1-800-MEDICARE (1-800-633-4227).
Your costs in Original Medicare
You pay 20% of the Medicare-approved amount.