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36.4.18 Hyperbaric Oxygen Therapy (HBOT)
Procedure code 99183 is limited to one session per day, any provider.
Note: Although oxygen may be administered by mask, cannula, or tube in addition to the hyperbaric treatment, the use of oxygen by mask, or other device, or applied topically is not considered hyperbaric treatment in itself.
Texas Medicaid recognizes the following indications for HBOT:
• Air or gas embolism
•Carbon monoxide/smoke inhalation
•Compromised skin grafts and flaps
•Crush injuries/acute traumatic ischemias
•Decompression sickness
•Enhanced healing in selected problem wounds
•Exceptional blood loss (anemia)
•Gas gangrene (clostridial myonecrosis)
•Necrotizing soft tissue infections
•Radiation tissue damage (osteoradionecrosis)
•Refractory osteomyelitis
•Thermal burns
Texas Medicaid does not consider HBOT medically necessary for the treatment of cerebral palsy or traumatic brain injury. HBOT is not reimbursed for these diagnoses.
Documentation required by the physician includes, but is not limited to:
•Ordering the HBOT treatments.
•Documentation of medical necessity.
•An established plan of care specifying the goals of HBOT.
•The estimated number of treatments including revisions made as appropriate and justification for extending treatments.
•Level of supervision provided.
The physician must be in constant attendance of hyperbaric oxygen therapy during compression and decompression of the chamber.
When requesting reimbursement for HBOT, providers must use one of the following diagnosis codes:
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