Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers

Your physician determines whether HBOT is appropriate. The most widely used criteria come from Medicare's coverage rules, and many physicians use them as a practical guide. Under NCD 20.29, all three of these must be true:

1. You have type 1 or type 2 diabetes and a lower-extremity wound caused by diabetes.
2. The wound is Wagner grade 3 or higher.
3. You have completed an adequate course of standard wound therapy and the wound has shown no measurable signs of healing for at least 30 days.

What the Wagner grades mean

The Wagner scale describes how deep a diabetic foot ulcer goes and whether infection or gangrene is present.

At Generations Wellness, care is directed by Dr. Rajwinder Singh Bahia, MD, and sessions take place in hard-shell monoplace chambers. A monoplace chamber holds one person. You lie comfortably, breathe medical-grade oxygen at the pressure your physician prescribes, and stay in communication with staff throughout.

• Number of sessions: commonly 20 to 40, depending on how your wound responds.
• Frequency: usually once a day, five days a week.
• Session length: about 90 to 120 minutes including the time to pressurize and depressurize.
• Pressure: commonly 2.0 to 2.5 ATA for wound indications, as prescribed by your physician.
• Reassessment: wounds are measured and reviewed regularly. Medicare's rules require re-evaluation at least every 30 days, and a course should continue only if the wound is measurably improving.

Your regular wound care continues during the course. Dressing changes, offloading and visits with your podiatrist or wound clinic stay in place, and HBOT is added on top. To picture a typical visit, read what to expect at your first session.

Blood sugar on treatment days

In people with diabetes, blood sugar can drop during an HBOT session. For that reason, checking glucose before and after sessions is a common step at hyperbaric centers, and patients are usually asked to eat normally and take their medications as directed unless told otherwise. Our team explains its own process at your assessment, so tell us about your diabetes medications, especially insulin, and bring your glucose meter if you use one.

Generations Wellness currently offers HBOT on a self-pay basis. We do not bill insurance, Medicare or Medi-Cal today while we work toward insurance contracts, and we will tell you that plainly before you begin.

It is still worth knowing how coverage works in general, because diabetic foot ulcers are one of the indications insurance may cover. Original Medicare covers HBOT for diabetic wounds of the lower extremities when the three criteria above are met: diabetes, Wagner grade 3 or higher, and at least 30 days of standard care without measurable healing. Coverage stops if the wound shows no measurable improvement during any 30-day period. At facilities that bill Medicare, patients typically pay the Part B deductible ($283 in 2026) and then 20% coinsurance, which published estimates put at roughly $90 to $115 per session. Commercial and Medicare Advantage plans commonly require prior authorization.

For self-pay care, published national ranges for medical-grade HBOT at independent centers run about $150 to $450 per session, and a 20- to 40-session course adds up quickly. These are ranges, not quotes. We review pricing for your physician-recommended plan clearly at your consultation. If you likely qualify for Medicare coverage, tell us when you call and we'll explain your options honestly, including when another setting may make more financial sense.

For details, see Medicare's Wagner grade 3 rule and HBOT cost per session and per course.