Hyperbaric Oxygen Therapy and Topical Oxygen Therapy – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers hyperbaric oxygen therapy (HBOT) only for the explicitly listed indications — e.g., acute traumatic peripheral ischemia, air/gas embolism, severe anemia when transfusion is unavailable, avascular necrosis, carbon monoxide poisoning, central retinal artery occlusion, refractory chronic osteomyelitis, gas gangrene, compromised grafts/flaps, decompression sickness, delayed radiation injuries, diabetic lower‑extremity wounds, ISSHL, intracranial abscess, necrotizing soft‑tissue infections, and second/third‑degree burns — and considers HBOT for all other indications, mild HBOT (mHBOT, <1.4 ATA) and topical oxygen therapy (TOT) unproven and not medically necessary. Coverage requires meeting the HBOT definition (≥1.4 ATA with near‑100% oxygen) and indication‑specific documentation (e.g., objective confirmation or timing for acute conditions, evidence of failed standard therapy such as inadequate DFU healing after ~4 weeks, and verification of member benefits).