NHA’s Standardization Initiative

There are approximately 1000 free-standing and hospital-bed hyperbaric clinics across the United States. Hospital based treatments range between $1300- $2500 per treatment. Free-standing clinic treatments range between $125 – $350 per treatment.

Hospital-based clinics are typically restricted to providing hyperbaric treatment for only 15 medical conditions (indications) that are currently covered by insurers in the United States. So many patients go to free-standing clinics, and pay out-of-pocket for treatment for their non-covered 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.

Ultimately, patients and clinics suffer from disparities between the two models. Those disparities can limit coverage, and limit access to treatment.

The National Hyperbaric Association will help to improve standardization, so that hyperbaric treatment is more accessible for patients, less of a risk to insurers, and more sustainable for clinic owners by:

  • Collaborating with practitioners of both hospital-based and free-standing clinic models.
  • Advocating for consistent certification across both models.
  • Creating and helping to implement sensible and effective standards for free-standing clinics.
  • Working with certifying bodies to improve standardization of  treatments.
  • Standardizing the documentation of patient outcomes.
  • Creating a central data repository for the collection and reporting of outcomes.
  • Improving the national perception of the benefits of hyperbaric treatment.