HBOT is hyperbaric oxygen therapy. NYS Medicaid covers HBOT for limited conditions and as an adjunctive therapy- ONLY in Article 28 OPD and DT&C settings.
HBOT reimbursement is allowed foe the following limited conditions:
- Gas embolism AND
- Gas gangrene
- Decompression illness
- acute carbon monoxide intoxication with or without concomitant cyanide poisoning
Some adjunct therapy that HBOT reimbursement is allowed for are:
- acute peripheral arterial insufficiency
- Crush injuries
- Reattachment of severed limbs
For a full list please click here– in addition to the non covered conditions list.
Proper billing and coding for facilities:
- G0277 (Hyperbaric oxygen under pressure, full body chamber, per 30-minute interval) for each 30-minute interval of HBOT.
Proper billing and coding for physician services:
- 99183-Physician attendance and supervision of HBOT, per session
Physicians are also allowed to bill an EM code on the same DOS with a modifier 25, if physician performs separately Identifiable services.
Find this information useful? Follow my blog for more!
- NYS Medicaid: proper billing and coding for HBOT
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- MA Common Wealth Alliance: new prior auth req BH services
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