Is Hyperbaric Oxygen Therapy Covered by Insurance?

The short answer

Insurance usually pays for HBOT only when it treats a condition on the insurer's approved list and your records show you meet its criteria. Medicare's list is set by a national rule called National Coverage Determination (NCD) 20.29 (CMS). Most large private insurers publish their own lists, which overlap with Medicare's but are not identical.

Wellness sessions and mild (soft-shell) chambers are a different story. UHMS calls mild HBOT unproven, and UnitedHealthcare's policy says it is not medically necessary for any indication, so you would usually pay in full.

What Medicare covers: the 15 conditions in NCD 20.29

Medicare covers HBOT for 15 conditions listed in NCD 20.29, the version effective April 3, 2017 (CMS, NCD 20.29). Several are covered only as an add-on to standard treatment, not on their own.

The diabetic wound criteria

For diabetic foot and leg wounds, you must meet all three of these (CMS, NCD 20.29):

1. You have type 1 or type 2 diabetes and a lower-extremity wound caused by diabetes.
2. The wound is Wagner grade III or higher. (The Wagner scale grades how deep a diabetic foot wound goes.)
3. An adequate course of standard wound therapy has failed.

Medicare treats standard therapy as failed when there are no measurable signs of healing after at least 30 days. To keep paying, Medicare also expects measurable healing during each 30-day period of HBOT.

What Medicare does not cover

All other uses are not covered. The NCD names some examples, including pressure and stasis ulcers, chronic peripheral vascular insufficiency, thermal burns, heart attack, sickle cell anemia, multiple sclerosis, arthritis and acute cerebral edema (CMS, NCD 20.29).

Medicare pays only for HBOT given in a chamber, including one-person chambers (Medicare.gov). Topical oxygen, which is applied to a wound rather than the whole body, was removed from NCD 20.29 in 2017. Since then, the regional Medicare contractors decide whether to cover it (CMS).

What you pay with Medicare

With Original Medicare, you usually pay 20% of the Medicare-approved amount for HBOT, and the Part B deductible may apply (Medicare.gov). The Part B deductible is $283 in 2026 (Medicare.gov, 2026).

Your actual cost also depends on other insurance you have, the type of facility, and whether your doctor accepts assignment (agrees to take the Medicare-approved amount as full payment) (Medicare.gov).

Medigap. A Medigap (Medicare Supplement) policy can help pay your share in Original Medicare, such as coinsurance and deductibles (Medicare.gov).

Medicare Advantage. These plans must cover all medically necessary services that Original Medicare covers. But they may require prior authorization, and you may need to use in-network providers for non-emergency care. You can't buy Medigap to cover a Medicare Advantage plan's out-of-pocket costs (Medicare.gov).

Prior authorization. In most cases, Original Medicare does not require approval in advance (same source). Medicare Advantage plans may, so call your plan before your first session.

Does Medicaid cover HBOT?

It depends on your state. Each state runs its own Medicaid program, and many people get Medicaid through a managed care plan with its own rules. Ask your state Medicaid agency or your Medicaid plan whether HBOT is covered for your condition and whether prior authorization is needed.

Private insurance: BCBS, Aetna, UnitedHealthcare and Cigna

The large insurers we checked each publish a medical policy for HBOT. All of them cover a list of conditions similar to Medicare's and to the indications recognized by the Undersea and Hyperbaric Medical Society (UHMS) (UHMS, 2020). None of them guarantees coverage. Your plan documents decide, and coverage varies by plan.

The lists don't match exactly. For example, Medicare covers actinomycosis as an add-on treatment, but Cigna lists it as not medically necessary (CMS; Cigna, 2026). That's why you should read your own plan's policy.

Does Blue Cross Blue Shield cover HBOT?

Usually for listed medical conditions, but it depends on your Blue plan. Blue Cross Blue Shield is not one insurer. Regional companies run the plans and publish their own policies. For example, Health Care Service Corporation (HCSC) runs the Blue plans in Illinois, Montana, New Mexico, Oklahoma and Texas and publishes the policy above (BCBSIL, 2026). Search your Blue plan's website for its "hyperbaric oxygen" medical policy, or call the number on your card.

What is usually not covered

Off-label and wellness uses are usually not covered. Cleveland Clinic notes that medical spas and alternative medicine centers promote HBOT for things like anti-aging, autism, COVID-19, depression, sports injuries and stroke, and says there currently isn't enough research to show it works safely and effectively for these (Cleveland Clinic, 2023). The Aetna and Cigna policies above name many of the same conditions as unproven or not medically necessary.

Mild HBOT is also usually not covered. UHMS calls treatment at "minimally elevated chamber pressures (mild hyperbaric oxygen)" unproven (UHMS, 2020). UnitedHealthcare's policy says mild HBOT is "unproven and not medically necessary for any indication" (UnitedHealthcare, 2026). Our mild vs hard-shell HBOT guide explains the difference.

How to get HBOT approved

These steps give you the best chance of approval:

1. Start with your doctor. Ask whether your condition is on your insurer's list and whether you meet the criteria. Our guide to what HBOT is explains which conditions it is used for.
2. Get a referral. Many plans expect a referral to a hyperbaric or wound care center.
3. Build the records. For diabetic wounds, insurers want the Wagner grade and proof that at least 30 days of standard wound care didn't work (CMS, NCD 20.29).
4. Ask about prior authorization. Medicare Advantage and private plans may require it. Don't start until it's approved in writing.
5. Ask the clinic to verify your benefits. Ask for an estimate using the billing codes: G0277 for each 30 minutes in the chamber and 99183 for the doctor's supervision of each session (UnitedHealthcare, 2026).

If insurance says no

You can usually appeal. Medicare lets you appeal a coverage or payment decision by Original Medicare or by a Medicare Advantage plan, and each decision letter explains the next step (Medicare.gov). With private insurance, you have the right to an internal appeal and to an external review by an independent third party (HealthCare.gov).

Your doctor can help by sending records that show how you meet the policy's criteria. Also ask whether the clinic is in your plan's network. An out-of-network clinic can cost more even when the treatment is covered.

If you decide to pay yourself, compare cash prices first. Our HBOT cost guide shows published Medicare rates and hospital cash prices.