NHA’s Reimbursement Initiative
Only 15 hyperbaric treatments are currently approved for reimbursement by the Centers for Medicare and Medicaid Services (CMS).
In the United States, patients suffering from these 15 medical conditions, referred to as “indications”, may be authorized to receive hyperbaric treatment and insurance coverage for their medical conditions.
- Acute carbon monoxide intoxication
- Decompression illness
- Gas embolism
- Gas gangrene
- Acute traumatic peripheral ischemia. HBO therapy is a valuable adjunctive treatment to be used in combination with accepted standard therapeutic measures when loss of function, limb, or life is threatened.
- Crush injuries and suturing of severed limbs
- Progressive necrotizing infections (necrotizing fasciitis)
- Acute peripheral arterial insufficiency
- Preparation and preservation of compromised skin grafts (not primary management of wounds)
- 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 in patients who meet the following criteria:
- Patient has type1 or type 11 diabetes and has a lower extremity wound that is due to diabetes
- Patient has a wound classified as Wagner grade 111 or higher
- Patient has failed an adequate course of standard wound therapy.
In many other countries, hyperbaric treatment is safely and effectively used for dozens of treatments that are off-label in the United States. In many cases, those indications are paid for by some form of medical insurance.
Research in the United States and abroad has shown that hyperbaric treatment can be safe and effective for many other indications than the 15 currently covered in the U.S., such as Cerebral Palsy and Fibromyalgia.
- Cutaneous, decubitus, and stasis ulcers
- Chronic peripheral vascular insufficiency
- Anaerobic septicemia and infection other than clostridial
- Skin burns (thermal)
- Senility. (Vascular, Alzheimer’s or FTD)
- Myocardial infarction
- Cardiogenic shock
- Sickle cell anemia
- Acute thermal and chemical pulmonary damage, such as smoke inhalation with pulmonary insufficiency
- Acute or chronic cerebral vascular insufficiency
- Hepatic necrosis
- Aerobic septicemia
- Nonvascular causes of chronic brain syndrome
- Pick’s disease
- Alzheimer’s disease
- Korsakoff’s disease
- Systemic aerobic infection
- Organ transplantation
- Organ storage
- Pulmonary emphysema
- Exceptional blood loss anemia
- Multiple Sclerosis
- Arthritic Diseases
- Acute cerebral edema
- Cerebral Palsy
- Traumatic Brain Injury
- Post Traumatic Stress Disorder (PTSD)
- Stem Cell Recruitement
Affecting positive change
The National Hyperbaric Association will align the past, current, and future research and outcomes of hyperbaric professionals across the United States, and the world, to demonstrate the efficacy of hyperbaric treatment for additional indicatons.
Broadening what indicators are covered by insurance will result in more patients having access to hyperbaric treatment that can help them to heal faster, recover earlier in their treatment process, and recover with less complications and restrictions.
To achieve results we will…
- Gather data to create compelling arguments for broader use of hyperbaric treatment.
- Collaborate with providers and insurers to develop cost benefit analyses, and risk mitigation strategies, that can help increase the number of approved indications.
- Demonstrate hyperbaric treatment efficacy to policy makers and government officials.