Hyperbaric Oxygen Therapy (HBOT) 2.01.07
Excellus BlueCross BlueShield considers systemic hyperbaric oxygen therapy (HBOT) in a pressurized chamber medically appropriate for listed indications, including acute air or gas embolism, acute carbon monoxide poisoning, decompression sickness, idiopathic sudden sensorineural hearing loss, central retinal artery occlusion, and non-healing lower extremity wounds from diabetes that meet defined criteria. Topical HBOT is considered investigational, and systemic HBOT for all other listed indications, including acute ischemic stroke and migraine, is also considered investigational. The 07/16/26 annual review left the policy intent unchanged.