Does Medicare Cover Hyperbaric Oxygen Therapy?
This article was updated on: 10/20/2018
For certain medical conditions, health-care providers may recommend hyperbaric oxygen therapy, which is when you breathe oxygen in a special pressurized chamber. Please note that hyperbaric oxygen therapy has not been clinically proven for the treatment of autism, cancer, or diabetes. The U.S. Food and Drug Administration (FDA) has only cleared hyperbaric chambers (medical devices) for hyperbaric oxygen therapy in 13 specific situations, such as decompression sickness, acute thermal burns, and carbon monoxide poisoning, among others. Read on to learn more about the uses, risks, and Medicare coverage of hyperbaric oxygen therapy, which is different from regular oxygen therapy.
What is hyperbaric oxygen therapy?
According to the U.S. National Library of Medicine (MedlinePlus), hyperbaric oxygen therapy is when a patient enters a special pressurized chamber (or a smaller unit in an outpatient center) where the air pressure is about two and a half times the normal pressure of the atmosphere. According to the FDA, this highly pressurized environment can be up to three times higher than normal atmospheric pressure, and it helps your lungs absorb up to three times more oxygen than normal, which accordingly increases the oxygen levels in the blood.
Then, according to MedlinePlus, your blood can carry more oxygen to your body’s organs and tissues, which can help wounds (especially infected wounds) get better faster. According to the FDA, an increase in blood oxygen may also improve oxygen delivery to the body’s tissues to minimize injury.
According to MedlinePlus, hyperbaric oxygen therapy may be used to treat:
- Dangerous air bubbles in the blood vessels (known as air or gas embolisms)
- Specific infections in the brain or sinuses
- Gas gangrene
- Infections of the skin that cause tissue death (necrotizing soft tissue infections)
- Bone infections (osteomyelitis) when other treatments have not been effective
- Skin grafts
- Radiation injury – for example, after radiation therapy
- Wounds that haven’t improved with other treatments, such as diabetic foot ulcers
- Carbon monoxide poisoning
Some practitioners believe hyperbaric oxygen therapy is helpful in treating a number of other health conditions. However, according to the FDA, hyperbaric oxygen therapy has not been established safe or effective for use in conditions like Alzheimer’s disease, Parkinson’s disease, heart disease, or stroke, among others.
What are the risks of hyperbaric oxygen therapy?
Please note that hyperbaric oxygen therapy may hold a risk for a mild or serious injury, according to the U.S. Food and Drug Administration (FDA), who approves the use of hyperbaric chambers. There is also a risk of fire in such an oxygen-rich environment.
According to the FDA, patients who receive hyperbaric oxygen therapy have an increased risk for:
- Mild injuries like sinus pain, ear pressure, or painful joints
- Serious injuries like paralysis or air embolism
You may want to discuss the risks and benefits of the treatment with your health-care provider.
What should I expect during hyperbaric oxygen therapy?
According to the Mayo Clinic, you may get hyperbaric oxygen therapy in an individual chamber or room designed for several people to use at once. You’ll be asked to sit or lie on a special table or bed, and you may be asked to breathe the oxygen through a face mask or a lightweight hood placed over your head. Medical staff monitor you throughout the treatment.
The treatment usually lasts about two hours, and you may experience a sense of fullness in your ears as a result of the increased pressure. This is usually relieved by yawning or swallowing. Also, you may feel tired or hungry after hyperbaric oxygen therapy, but you should be able to continue your normal activities as soon as it’s complete, according to the Mayo Clinic.
Does Medicare cover hyperbaric oxygen therapy?
If you are enrolled in Original Medicare (Part A and Part B), hyperbaric oxygen therapy may be covered under Medicare Part B if used to treat certain approved conditions.
Conditions when you may be covered to receive hyperbaric oxygen therapy under Medicare Part B may include (but are not limited to):
- Acute carbon monoxide intoxication
- Decompression illness
- Gas embolism
- Gas gangrene
- Acute traumatic peripheral ischemia
- Crush injuries and suturing of severed limbs
- Progressive necrotizing infections
- Cyanide poisoning
- Diabetic wounds of the lower extremities, if you meet certain criteria
The treatment must be medically necessary and administered in a special hyperbaric oxygen therapy tube or chamber. In some states (Illinois, Michigan, and New Jersey), you may be required to get prior authorization before receiving the treatment unless it’s an emergency. Part B will pay 80% of all allowable charges; you are responsible for the remaining 20% plus any applicable Part B deductible.
If you would like more information about hyperbaric oxygen therapy and Medicare plan options, I’m happy to answer your questions. To request a phone call or email with personalized information, click one of the links below. You also can view a list of available plan options in your area by clicking the Compare Plans button. You can find out more about me by clicking on the “View profile” link below.
For more information about hyperbaric oxygen therapy, please see:
“Hyperbaric Oxygen Therapy: Don’t Be Misled,” U.S. Food and Drug Administration (FDA), last modified May 10, 2016, http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm364687.htm
“Hyperbaric Oxygen Therapy,” U.S. National Library of Medicine (MedlinePlus), last modified August 30, 2014, https://medlineplus.gov/ency/article/002375.htm