What Researchers Did
Researchers reviewed HBOT insurance policies of the 60 largest U.S. health insurers for compromised surgical flaps and grafts, then created a reimbursement algorithm for prescribing physicians.
What They Found
53 of 60 insurers (88%) had HBOT policies; 47% required prior authorization and 62% required continuing authorization. Most permitted clinical judgment to define flap compromise, and 22 insurers specified required documentation including medical records, images, and signs of healing.
What This Means for Canadian Patients
This study is U.S.-focused. Canadian patients seeking HBOT for compromised tissue reconstruction should consult their provincial health authority and the treating hyperbaric facility about coverage criteria, as the landscape differs significantly from the U.S.
Canadian Relevance
No direct Canadian connection identified. Coverage landscape differs significantly under Canadian provincial health insurance systems.
Study Limitations
Policies were reviewed at a single point in time and U.S. insurance policies change frequently, limiting how long these findings remain current.