Medicare billing for hyperbaric oxygen therapy

Hospitals are meant to bill HCPCS code G0277 for hyperbaric oxygen therapy. This code is billed in 30-minute increments. Treatment time (for billing purposes) starts at the beginning of chamber pressurization and ends when chamber depressurization is finished. There must be more than 15 minutes in order to bill an increment (see table below).

Physicians are meant to bill CPT code 99183 for their professional service. This code is billed one per treatment.

Under the Medicare program, the United States is divided into several jurisdictions, each containing several States. Medicare claims are processed by the Medicare Administrative Contractor (MAC) for that jurisdiction. Each MAC writes its own Local Coverage Determination (LCD) for specific covered services such as hyperbaric oxygen therapy. An LCD on hyperbaric oxygen therapy should contain: limitations of coverage; a list of covered conditions and their appropriate diagnosis codes; and documentation requirements.

You can find a local coverage document on hyperbaric oxygen therapy for almost every MAC by searching the Medicare Coverage Database at the following website: www.cms.gov/medicare-coverage-database/

For more instructions on how to find the Medicare coverage policy that applies to you.

Author:
Robert B. Sheffield, BA, CHT
Director of Education
International ATMO, Inc.