Key takeaways
- HR 1336 (Veterans National Traumatic Brain Injury Treatment Act, Rep. Greg Murphy R-NC) passed the House VA Committee in May 2025. Would require a VA five-year pilot providing HBOT to veterans with TBI/PTSD.
- S.862 (HBOT Access Act of 2025, Sen. Tuberville R-AL) is the Senate counterpart, directing the VA to furnish HBOT to veterans with TBI/PTSD.
- Sen. Hoeven (R-ND) and Sen. Cramer (R-ND) introduced additional legislation expanding veteran HBOT access.
- 10 US states have passed HBOT-for-veterans legislation: Texas (HB271), Oklahoma, Indiana, Arizona, Kentucky, Florida, North Carolina, Wyoming, Maryland, Virginia.
- The VA HBOT clinical demonstration program currently operates in California, Florida, Oklahoma, and Texas — a limited federal footprint pending the pending legislation.
The federal push in 2025
Veteran-specific HBOT legislation gained meaningful momentum in Washington through 2025. Two major federal bills are in play, together with earlier legislation from the North Dakota delegation.
HR 1336 — Veterans National Traumatic Brain Injury Treatment Act
Sponsored by Rep. Greg Murphy (R-NC), HR 1336 would require the Department of Veterans Affairs to conduct a five-year pilot program providing hyperbaric oxygen therapy to veterans with traumatic brain injury or post-traumatic stress disorder. The bill passed the House Veterans Affairs Committee in May 2025, clearing the first major procedural hurdle. House floor consideration and Senate action remain pending as of late 2025.
S.862 — HBOT Access Act of 2025
Senator Tommy Tuberville (R-AL) introduced S.862, which would amend federal law to direct the VA Secretary to furnish HBOT to veterans with TBI or PTSD. The Senate version is broader than the House pilot framework.
Additional legislation
Senators Hoeven (R-ND) and Cramer (R-ND) introduced separate legislation supporting veteran HBOT access, framed around alternative therapy coverage for TBI and PTSD populations.
The state landscape
Federal legislation has moved slowly, but state-level programs have expanded aggressively. As of 2025, ten US states have passed legislation calling for HBOT access for service members with TBI and/or PTSD:
| State | Program |
|---|---|
| Texas | HB 271 — Veterans Recovery Pilot Program |
| Oklahoma | State-funded veteran HBOT access (pioneer program) |
| Indiana | Veterans HBOT access |
| Arizona | Veterans HBOT access |
| Kentucky | Veterans HBOT access |
| Florida | Florida Department of Veterans Affairs HBOT program |
| North Carolina | Veterans HBOT access |
| Wyoming | Veterans HBOT access |
| Maryland | Veterans HBOT access |
| Virginia | Veterans HBOT access |
Program structures vary. Some are fully state-funded with HBOT delivered at state-affiliated or contracted facilities. Others are hybrid models partnering with private HBOT providers. All operate outside the UHMS indication list — TBI and PTSD remain off-label — but states have chosen to fund access based on the veteran-specific research signal.
The VA clinical demonstration program
The VA currently operates an HBOT clinical demonstration program at select facilities in California, Florida, Oklahoma, and Texas. This is a limited footprint — meaningful for the veterans in those catchments but far from a national benefit.
The pending federal legislation would substantially expand this. HR 1336's five-year pilot framework would mandate a national pilot across more sites, structured enrollment, and formal outcome tracking. If enacted, it would be the largest federal commitment to veteran HBOT access to date.
The evidence base
The research supporting veteran HBOT is a mix of veteran-specific and civilian-TBI studies:
- Harch et al. 2017 (Med Gas Res) — the strongest veteran-specific prospective trial. 29 veterans with mTBI + PTSD, 40 sessions at 1.5 ATA. Significant cognitive, PTSD symptom, QoL, depression, and anxiety improvements.
- Boussi-Gross 2013 (PLOS ONE) — civilian TBI RCT, 2.0 ATA, 40 sessions. Cognitive gains in chronic mTBI including years post-injury.
- Tal 2017 (Restor Neurol Neurosci) — perfusion-MRI evidence of HBOT-induced angiogenesis in chronic post-concussive brain tissue.
- Hadanny & Efrati 2020 (Biomolecules) — review consolidating 2.0 ATA neurological HBOT evidence.
The DoD HOPPS (Wolf 2012) and BRIMS (Cifu 2014) RCTs returned negative primary endpoints but have been widely criticised for sham-chamber confounds — the sham arms delivered ~1.3 ATA that may itself have been active. These are not clean refutations of HBOT efficacy.
Advocacy and support networks
Several organisations actively work on veteran HBOT access and policy:
- TreatNOW Coalition — veteran advocacy focused on HBOT access expansion
- Special Operations Association of America (SOAA) — HBOT access for Special Operations veterans
- International Hyperbaric Medical Foundation (IHMF) — research funding and program support
- Team Veteran Foundation — direct veteran HBOT access programs
How a veteran can access HBOT today
- State-funded program — if you reside in one of the 10 states with legislation, start with your state Veterans Affairs office.
- VA clinical demonstration site — CA, FL, OK, TX — check with your VA regional office for current enrollment status.
- Clinical trial enrollment — our Clinical Trials Tracker pulls live listings from ClinicalTrials.gov for veteran HBOT studies.
- Private HBOT facility — cash-pay typically $6,000–$18,000 for a full course; some non-profits subsidise access.
- Advocacy organisation referral — TreatNOW and SOAA maintain referral networks.
Where it goes from here
The 2025 legislative momentum is the strongest federal signal in years. If HR 1336 or S.862 passes, the resulting VA pilot would substantially expand access and generate the outcome data needed for formal UHMS and CMS review of TBI/PTSD HBOT. If they fail, the state-by-state expansion will continue to be the main access pathway.
For a deeper look at the veteran HBOT landscape — state programs, VA access pathways, and the evidence base — see our Veterans Resources Hub.
Frequently Asked Questions
Is HBOT covered by the VA for TBI/PTSD?
Not as a national benefit. The VA's current HBOT clinical demonstration program covers select sites in CA, FL, OK, and TX. Pending federal legislation (HR 1336, S.862) would expand this to a formal five-year national pilot.
Which states have HBOT-for-veterans programs?
Ten states as of 2025: Texas (HB271 Veterans Recovery Pilot Program), Oklahoma, Indiana, Arizona, Kentucky, Florida, North Carolina, Wyoming, Maryland, and Virginia. Program structure varies — some are fully state-funded, others are hybrid with private HBOT provider networks.
What is the evidence base?
Harch et al. 2017 (Med Gas Res) is the strongest veteran-specific trial, showing cognitive, PTSD, and quality-of-life improvements at 1.5 ATA. The civilian TBI evidence (Boussi-Gross 2013, Tal 2017, Hadanny & Efrati 2020) uses 2.0 ATA and informs the clinical dosing. DoD HOPPS and BRIMS trials produced negative primary endpoints but have been criticised for sham-chamber confounds.
How can a veteran access HBOT today?
Pathways: (1) state-funded program if resident of one of the 10 participating states; (2) VA clinical demonstration site; (3) clinical trial enrollment via ClinicalTrials.gov; (4) private HBOT clinic cash-pay or non-profit subsidised. The TreatNOW Coalition and SOAA Veterans provide advocacy and referral assistance.
