How to Choose a Hyperbaric Oxygen Therapy Clinic: A Checklist

The Short Version

A good hyperbaric oxygen therapy (HBOT) clinic has five things you can check before booking: a physician who assesses you and supervises treatment, trained and certified chamber staff, a chamber that suits your condition, written safety and emergency procedures, and clear answers about evidence and price. Accreditation is the fastest way to confirm most of them. In the US, the FDA advises patients to use a hospital or facility accredited by the Undersea and Hyperbaric Medical Society (UHMS).

In an emergency, do not shop for a clinic. For suspected carbon monoxide poisoning or decompression illness, call your local emergency number first. Emergency treatment happens in hospital chambers. Divers can also call the DAN Emergency Hotline on +1-919-684-9111.

Step 1: Match the Clinic to Your Reason for Treatment

• Accepted medical uses. As of July 2021, the FDA had cleared hyperbaric chambers for a defined list of conditions, including decompression sickness, carbon monoxide poisoning, radiation injury, compromised skin grafts and flaps, severe bone and skin infections, sudden hearing loss and non-healing diabetic foot ulcers. The UHMS says all its approved indications require near-100% oxygen at a minimum of 2.0 ATA (atmospheres absolute).
• Investigational or wellness uses. Many clinics offer HBOT for other goals. The FDA warns that some claims are unproven. For example, HBOT devices are not proven to cure cancer, Lyme disease, autism or Alzheimer's disease.
• Mild hyperbaric sessions. Soft-shell chambers run below 1.4 ATA on air. The UHMS says this does not meet the definition of HBOT, so check which kind of chamber a clinic uses before comparing prices.

Step 2: Check Accreditation

Accreditation means an outside body has inspected how the facility runs. What is available depends on where you live.

United States. The UHMS Hyperbaric Facility Accreditation program evaluates the facility, equipment, staff and training through an on-site survey. The UHMS says it has surveyed and accredited more than 290 facilities in about 25 years, and that The Joint Commission recognises it as a complementary accrediting organisation. You can search the UHMS map of accredited facilities.

Europe. The European Code of Good Practice for HBOT, endorsed by the European Underwater and Baromedical Society (EUBS), says every hyperbaric facility should seek accreditation specific to hyperbaric operations. Where none is available locally, it should at least have its equipment and procedures externally validated. Arrangements differ by country:

• United Kingdom. NHS England's service specification for HBOT requires its commissioned providers to be registered with the Care Quality Commission and appraised by the British Hyperbaric Association (BHA) every five years.
• Germany. The association of German hyperbaric centres, the VDD, says its member chambers commit to standards for staff training, technical equipment, maintenance and inspection, and treatment protocols for each indication, and that it certifies centres with an independent inspection body.

A clinic without accreditation is not automatically unsafe, especially where no programme exists. It does mean you have to check each point below yourself.

Step 3: Confirm Physician Supervision

The UHMS guidelines for patients state that HBOT is the practice of medicine. Treatment should follow an evaluation and prescription by a licensed physician trained in hyperbaric medicine (at minimum a 40-hour UHMS-approved introductory course), and be supervised by a physician actively involved in your care.

• US board certification. Undersea and hyperbaric medicine is a recognised subspecialty. The American Board of Preventive Medicine certifies physicians in it, as does the American Board of Emergency Medicine for emergency physicians. Both require a fellowship of at least one year.
• Europe. The European Code of Good Practice sets the minimum team for every session. A multiplace chamber needs a hyperbaric physician, an attendant and an operator. A monoplace chamber needs a hyperbaric physician and an operator. The whole team should stay in the facility and be immediately available.

Ask directly: who is the medical director, and will a physician be on site during my sessions?

Step 4: Check the Chamber Staff's Training

The people running the chamber matter as much as the doctor.

• Certified Hyperbaric Technologist (CHT). In the US, the National Board of Diving and Hyperbaric Medical Technology awards the CHT credential to people who complete an approved hyperbaric training course and a supervised preceptorship, then pass an exam.
• UHMS minimum. Chamber operations should be run or directly overseen by staff who have completed an approved 40-hour hyperbaric medicine course, ideally with certification from a recognised body. Each facility should name a trained safety coordinator.
• Europe. The European Baromedical Association for Nurses, Operators and Technicians (EBAss) runs a European certification scheme with three levels: European Certified Hyperbaric Chamber Operator, Registered Nurse and Safety Manager. NHS England requires attendants and operators to have completed a curriculum meeting BHA or EBAss requirements.

Step 5: Match the Chamber Type to Your Needs

Step 6: Ask About Safety and Emergency Procedures

Chamber fires are rare but can be fatal, which is why safety systems are worth asking about. The UHMS published its patient guidelines in April 2025, after the death of a young boy during hyperbaric treatment. They list what patients should expect:

• FDA-cleared chambers (in the US), inspected daily and maintained on the manufacturer's schedule
• No flammable products or electrical or static-generating devices in the chamber
• A pre-treatment "time-out" safety check, and grounding straps in 100% oxygen monoplace chambers
• Continuous visual and audio monitoring, and regular documented emergency drills
• Clinic-issued or approved clothing, such as 100% cotton

In August 2025 the FDA also reminded facilities to follow manufacturer instructions, train staff and supervise patients for the whole treatment, and to keep electrical devices out of chambers.

Step 7: Questions to Ask Before You Book

1. Is the facility accredited, and who is the medical director?
2. Are your chamber staff certified (CHT in the US, EBAss in Europe)?
3. What pressure and gas will I receive, and in which type of chamber?
4. Is my condition an accepted indication? If not, what evidence supports treating it?
5. How many sessions do you expect, and how will you measure progress?
6. What happens in an emergency, and when did you last run a drill?

Step 8: Look for Price Transparency

Prices vary too much between countries and providers to give a reliable range, so compare written quotes. A transparent clinic will tell you:

• The price per session and for the full planned course
• What is included: the physician assessment, follow-up reviews and any wound care
• Whether insurance or public funding may apply, and what you pay if it does not
• The refund policy if you stop early

Coverage for accepted indications is narrower than many people expect. US Medicare covers HBOT only for conditions listed in national coverage determination 20.29. For diabetic wounds, it requires evaluation at least every 30 days and stops covering treatment if a wound shows no measurable signs of healing within any 30-day period. In England, the NHS specialised HBOT service covers decompression illness and gas embolism, while several other uses, including carbon monoxide poisoning and diabetic foot ulcers, are listed as not routinely commissioned. Our guide to HBOT insurance coverage explains prior authorisation and what insurers ask for.

Red flags

• Promises to cure conditions the FDA says HBOT is not proven to treat
• No medical screening before your first session
• Pressure to buy a large, non-refundable package upfront
• Vague answers about chamber pressure, staff training or supervision

Your Clinic Checklist

Start Your Search

hyperbaric.app lists 1,632 HBOT facilities in 68 countries. Browse HBOT clinics near me, or search by country, for example clinics in the United States, clinics in the United Kingdom and clinics in Germany. For a breakdown of chamber types and treatments across the directory, see our HBOT statistics. Listings show what each clinic reports, so use the checklist above to confirm the details before you book.

Sources

• Undersea and Hyperbaric Medical Society, Ten Guidelines for Patients and Referring Physicians in Selecting Safe Hyperbaric Oxygen Treatments (April 2025).
• Undersea and Hyperbaric Medical Society, Hyperbaric Facility Accreditation Program and accredited facilities map.
• Undersea and Hyperbaric Medical Society, UHMS Position Statement: Low-Pressure Fabric Hyperbaric Chambers (revised 2018).
• U.S. Food and Drug Administration, Hyperbaric Oxygen Therapy: Get the Facts (consumer update, content current as of July 2021; archived copy).
• U.S. Food and Drug Administration, Follow Instructions for Safe Use of Hyperbaric Oxygen Therapy Devices: Letter to Health Care Providers (25 August 2025).
• Kot J, Desola J, Lind F, et al. A European code of good practice for hyperbaric oxygen therapy: Review 2022. Diving Hyperb Med. 2023;53(4 Suppl):1-17.
• NHS England, Hyperbaric oxygen therapy services (all ages): service specification (January 2025).
• Verband Deutscher Druckkammerzentren, Über den VDD (in German).
• National Board of Diving and Hyperbaric Medical Technology, Certified Hyperbaric Technologist training and certification.
• European Baromedical Association for Nurses, Operators and Technicians, European certified personnel in the hyperbaric field.
• American Board of Preventive Medicine, Undersea and Hyperbaric Medicine.
• American Board of Emergency Medicine, Undersea and Hyperbaric Medicine.
• Centers for Medicare and Medicaid Services, National Coverage Determination 20.29: Hyperbaric Oxygen Therapy.
• Heyboer M 3rd, Sharma D, Santiago W, McCulloch N. Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified. Adv Wound Care. 2017;6(6):210-224.
• Divers Alert Network, Emergency Assistance

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Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always ask your healthcare professional whether HBOT is appropriate for your condition. A clinic's presence in any directory does not constitute an endorsement of its services.