For referring physicians

Help Your Patients Heal With Medical-Grade HBOT

Clinical guidance on how HBOT works, the evidence by condition, what treatment involves and how to refer a patient.

Refer a Patient Explore the Evidence

Collaborative patient care

How HBOT fits into a patient’s care

Hyperbaric oxygen therapy (HBOT) combines increased ambient pressure with high-concentration oxygen. Under pressure, more oxygen dissolves in plasma and can reach tissue beyond normal hemoglobin transport. This change can affect tissue oxygenation, swelling, host defense and repair.

We assess each patient, select the treatment protocol and keep the referring physician informed. HBOT is used alongside the diagnosis and care plan already directed by the patient’s clinical team.

Clinical indications

Indications for HBOT

HBOT has a defined set of FDA-cleared uses. Most patients we serve come to us for indications beyond that list, where a growing body of research supports treatment on a case-by-case basis.

FDA-cleared indications

The FDA has cleared hyperbaric oxygen therapy for the following uses. Clinical suitability and insurance coverage still depend on the individual case.

  • Air or gas embolism
  • Carbon monoxide poisoning (with or without cyanide poisoning)
  • Gas gangrene (clostridial myositis and myonecrosis)
  • Crush injury, compartment syndrome, and other acute traumatic ischemias
  • Decompression sickness
  • Arterial insufficiencies (central retinal artery occlusion; selected problem wounds, including diabetic foot ulcers)
  • Severe anemia
  • Intracranial abscess
  • Necrotizing soft tissue infections
  • Refractory osteomyelitis
  • Delayed radiation injury (soft tissue and bony necrosis)
  • Compromised skin grafts and flaps
  • Acute thermal burn injury

The Undersea and Hyperbaric Medical Society additionally recognizes idiopathic sudden sensorineural hearing loss and avascular necrosis.

Participating MD Hyperbaric centers are in-network providers and accept insurance, including Medicare, for on-label referrals. Most plans require prior authorization; our team confirms which centers participate, verifies the patient’s benefits, and coordinates authorization with your office and the insurer.

Evidence summaries for the on-label referral areas:

Evidence by condition

HBOT literature by indication

Conditions marked on-label are recognized indications for HBOT, and participating centers accept insurance for them. For the off-label applications, evidence and clinical acceptance differ, this literature makes no claim of effectiveness or FDA clearance for HBOT, and each case requires physician review and informed consent.

On-label indication

Post-Radiation Injury

Delayed radiation injury, including radiation cystitis, osteoradionecrosis and soft tissue radionecrosis, is an FDA-recognized indication for HBOT. Injury can appear months to decades after radiotherapy, and treatment targets the underlying hypoxic, hypovascular tissue damage.

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On-label indication

Non-Healing Wounds

Advanced diabetic foot ulcers (Wagner Grade 3 or higher after 30 days of standard wound care) and compromised skin grafts and flaps are FDA-recognized indications. Threatened grafts and flaps respond best when HBOT starts within 24 to 72 hours of the first signs of compromise.

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On-label indication

Sudden Hearing Loss (SSNHL)

Idiopathic sudden sensorineural hearing loss is recognized by the Undersea and Hyperbaric Medical Society as an indication for HBOT, ideally started within two weeks of onset. Because treatment is time-sensitive, participating centers run an expedited pathway for these referrals.

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Performance & Longevity

Research here studies HBOT's effect on cognition, physical capacity, and cellular markers of aging in older and healthy adults. Findings are early and vary by protocol.

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Athletic Recovery & Injuries

Studies examine whether HBOT influences mitochondrial function, physical performance, and recovery in athletes and active adults.

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Chronic Pain & Fatigue

Most trials here focus on fibromyalgia, including randomized studies of HBOT's effect on pain, function, and brain activity.

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Concussions & TBIs

Randomized and imaging studies examine HBOT for persistent post-concussion symptoms after mild traumatic brain injury.

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Long COVID

Several randomized, sham-controlled trials assess HBOT for post-COVID cognitive, cardiac, and neurological symptoms.

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Neurological & Neuro-degenerative

This area spans distinct conditions, so the evidence is grouped by indication below rather than pooled.

Post-stroke

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PTSD

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Autism

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Chronic CO poisoning

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Oncology & Cancer Adjunct

HBOT's role in oncology is supportive and adjunctive. It is studied for managing complications such as radiation tissue injury and alongside standard cancer care. These references do not establish HBOT as a cancer treatment.

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Post-Surgical Recovery

Studies examine HBOT before or after surgery for its effect on healing, infection, and recovery, including randomized and meta-analytic evidence in selected procedures.

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Mechanisms of action

The science behind HBOT

The response to HBOT varies with the prescribed pressure and duration, the number of sessions, the tissue being treated and the underlying condition. Several of the mechanisms below may occur at the same time.

Hyper-oxygenation

Pressure increases the amount of oxygen dissolved in plasma and other body fluids. This gives oxygen another route into hypoxic tissue when red-cell delivery is limited. The effect depends on tissue perfusion, oxygen demand and the prescribed pressure.

Thom 2011 (opens in a new tab)

Mitochondrial support

HBOT changes oxygen availability and redox signaling inside cells. Studies suggest effects on mitochondrial respiration, ATP metabolism and antioxidant responses, although results vary by protocol and disease model. These findings explain a possible mechanism. Individual response remains uncertain.

Schottlender et al. 2021 (opens in a new tab)

Inflammation and edema modulation

Hyperoxia causes vasoconstriction while the extra oxygen dissolved in plasma remains available to tissue. In selected conditions, that may help control edema. HBOT also affects inflammatory signaling and the interaction between white blood cells and vascular endothelium. Timing and tissue state influence the response.

Thom 2011 (opens in a new tab) Lindenmann et al. 2021 (opens in a new tab)

Progenitor-cell mobilization

A small human study found an increase in circulating CD34-positive cells after a course of HBOT. The finding points to a possible role in repair signaling. The biomarker result cannot be translated directly into an equivalent increase in healing.

Thom et al. 2006 (opens in a new tab)

Neovascularization and tissue repair

Repeated HBOT sessions can affect growth-factor signaling, fibroblast activity, collagen production and new blood-vessel formation. These processes unfold over time and still depend on perfusion, infection control, wound care and the rest of the patient’s treatment plan.

Lindenmann et al. 2021 (opens in a new tab)

Antimicrobial and immune-support effects

Higher tissue oxygen levels can improve oxygen-dependent killing by white blood cells. They may also inhibit some organisms or make them more susceptible to treatment. For selected infections, HBOT is used as an adjunct to source control and antimicrobial therapy.

Thom 2011 (opens in a new tab)

Treatment environment

What treatment involves

A soft-sided chamber and a medical-grade hard chamber deliver different exposures. Operating pressure, oxygen delivery, device clearance and clinical supervision determine the dose a patient receives.

Mild hyperbaric

Soft-sided chamber

  • Usually operates below the pressures used in clinical HBOT protocols.
  • Pressure and oxygen delivery differ from a prescribed medical HBOT dose.
What we use

Medical-grade HBOT

Hard-sided chamber

Every patient at MD Hyperbaric is treated in a hard-sided medical chamber. It is the standard clinical HBOT is built around.

  • Supports physician-prescribed pressure and high-concentration oxygen delivery.
  • Patients are screened before treatment and monitored by trained clinical personnel.

Two ways to work with us

Refer a patient or request a consultation

Refer a patient

Ready to refer? Use the secure digital form or the printable referral. Every patient is clinically evaluated before treatment.

Refer a patient

Request a consultation

Have a clinical question first? Request a call with our Medical Director before you refer.

Request a consultation
  1. 1

    Send the referral

    Use the secure digital form or printable referral. Include the diagnosis, relevant history and current care plan.

  2. 2

    Clinical evaluation

    Our clinical team reviews the patient’s candidacy and contraindications. We will request any records needed to make an informed recommendation.

  3. 3

    Coordinate the plan

    When HBOT is appropriate, we coordinate treatment with the referring physician and the patient’s existing clinicians.

  4. 4

    Communicate progress

    Relevant treatment information and follow-up needs can be shared with the referring clinician to support continuity of care.

Refer a patient

Choose the referral format that works for your practice

Complete the embedded form below or download the printable version. You can also open the digital form in a separate tab.

Open digital form (opens in a new tab) Download printable form (opens in a new tab)

Not ready to refer?

Request a Medical Director consultation

Have a clinical question before you refer? Request a call with our Medical Director. Please do not include patient names, diagnoses, or other medical details in this form.

Common questions

Questions physicians ask

A patient rests inside our hard-sided Fortius420 chamber and breathes normally throughout the session. Most appointments last about 80 minutes, though the prescribed pressure and duration can vary.

HBOT has known risks and is performed under medical supervision. Before treatment, our care team checks contraindications. Consent covers the expected benefit and available alternatives, along with risks relevant to the prescribed protocol.

The most common adverse effect is pressure-related discomfort or barotrauma involving the ears or sinuses. Some patients experience temporary visual changes during a treatment course. Oxygen toxicity is uncommon, which is why the prescribed dose and clinical monitoring matter.

We give each patient chamber-specific instructions before the first session. Clothing and personal items must meet chamber requirements. Cosmetics and hair products should be removed, along with jewelry and anything else restricted by the chamber protocol. Patients should also tell us about tobacco or nicotine use because it can impair oxygen delivery.

Patients should tell the clinical team about any change that could affect pressure tolerance or safe monitoring, including:

  • Cold, flu, fever, sinus or nasal symptoms, or chest congestion
  • Possible pregnancy
  • Any medication changes
  • Diabetes and the timing of insulin or other glucose-lowering medication
  • Concerns or anxiety about treatment

Use the digital form on this page or download the printable referral. Every patient is clinically evaluated before treatment, and our team can coordinate the HBOT plan with the referring physician.

Yes, at participating centers, which are in-network providers and accept insurance, including Medicare, for on-label referrals: the recognized indications for which HBOT is an established standard of care. Our team confirms which centers currently participate, verifies the patient's benefits, and coordinates any required prior authorization with your office and the insurer before treatment begins. Most plans require it, and we run an expedited pathway for idiopathic sudden sensorineural hearing loss, where treatment is time-sensitive. At non-participating centers, and for off-label indications, HBOT remains a self-pay treatment.