CommercialCoverageMedium impact
Hyperbaric Oxygen Therapy (HBOT) 2.01.07
Excellus BlueCross BlueShield·Wound Care, Emergency Medicine, Endocrinology +2 more·Miscellaneous
Effective date
Jun 26, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has updated their Hyperbaric Oxygen Therapy (HBOT) policy effective June 26, 2025, defining specific covered indications including diabetic wounds, carbon monoxide poisoning, and various acute conditions. The policy establishes strict documentation requirements and treatment limits, with most patients not requiring more than 40 treatments.
Action Required
By June 26, 2025: Billing team must update HBOT billing procedures to ensure proper documentation of covered indications (diabetic wounds Wagner grade 3+, carbon monoxide poisoning, decompression sickness, etc.). Implement weekly wound measurement documentation for diabetic wounds and establish 40-treatment limits in billing system. Update prior authorization processes to verify 30 days of failed standard wound therapy before HBOT approval. Claims without proper documentation will be denied.