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).

Who's eligible?

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:
    1. You have Type 1 or Type 2 diabetes and have a lower extremity wound that’s due to diabetes.
    2. You have a wound classified as Wagner grade III or higher.
    3. You’ve failed an adequate course of standard wound therapy.
Note

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.

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