The UHMS accredits HBOT clinics through an on-site audit. The credential is voluntary, renews every three years, and lives mostly at hospital wound-care programs.
This guide explains what UHMS accreditation actually verifies, what it does not verify, and how it differs from FDA chamber clearance. Patients evaluating clinic credentials often conflate the two; they are independent.
The headline: of roughly 1,500 HBOT facilities in the US, only 140 hold UHMS accreditation as of 2026. Of those 140, fewer than half have "With Distinction" status.
What UHMS is
The Undersea and Hyperbaric Medical Society is the main professional body for HBOT in North America. It started in 1967 for Navy diver-physician training. It opened up to civilian HBOT in the 1990s.
UHMS publishes the Indications Manual, 14th edition 2019. This is the authoritative document for which conditions HBOT is clinically indicated to treat.
UHMS also runs the Clinical HBOT Facility Accreditation program, founded 2002. It audits sites every three years against set standards. Accreditation is voluntary.
UHMS is not a regulatory body. It does not have legal authority over HBOT facilities the way the FDA does over devices. Its accreditation is a credential, not a license.
What the accreditation audit checks
The UHMS audit covers safety, staffing, gear, and protocols. The standards are public.
Safety: chamber-fire plans, oxygen-toxicity response, and patient escape. Fire-safety gear, oxygen-safe materials, and grounding (NFPA 99 2024 sets the chamber-fire standard).
Staffing: a medical director with formal UHM training. Certified hyperbaric techs (CHTs) credentialed by the NBDHMT.
Equipment: FDA-cleared chambers (the K-numbers traceable in the openFDA 510(k) database). Documented chamber maintenance and pressure-vessel inspection records.
Protocols: written treatment plans that match the UHMS Indications Manual. Pre-treatment checks, including ear-equalization training and toxicity risk screening.
Quality work: tracking how patients do, and logging any safety events.
The audit is on-site. UHMS sends auditors to the facility for one to three days of direct observation (UHMS standards 2024). This is different from paper-only certifications.
What it does not check
UHMS accreditation does not verify that HBOT works for any one condition. The audit checks that the clinic follows the right safety steps. It does not check that the protocols actually help patients.
The accreditation also does not check off-label practice. UHMS audits assume the site treats UHMS-listed conditions. Clinics that mostly treat off-label uses do not pursue UHMS accreditation, because the framework does not fit.
UHMS does not audit single patient outcomes. The audit checks quality-assurance steps (is the clinic tracking outcomes? are events logged?). It does not check that outcomes are good.
UHMS does not audit billing or insurance practices. Whether a facility bills Medicare correctly under CMS LCD L33718, current 2024 is a CMS question, not a UHMS one.
The two accreditation tiers
UHMS accreditation has two tiers. The difference matters.
Accredited. Passed the standard on-site audit. Meets all baseline standards.
Accredited with Distinction. Passed the audit at a higher level. Requires above-baseline staffing, a long track record (usually 5+ years), and deeper quality-assurance paper trails.
As of 2026, our parse of the UHMS accredited facility directory shows roughly 60 facilities at "With Distinction" status and 80 at standard accreditation. The Distinction tier is the actual top of the credential pyramid.
For state-level breakdowns, see our Texas HBOT guide and Florida HBOT guide. Both states have multiple Distinction-tier facilities.
How accreditation differs from FDA clearance
These are two different things. Patients often conflate them. We will lay out the difference.
FDA 510(k) clearance is the federal process that lets a chamber be sold as a medical device. The FDA reviews safety, pressure testing, oxygen fit, and "substantial equivalence" to a prior cleared device.
UHMS accreditation is a private audit that checks a clinic's safety practices, staffing, and protocols. UHMS requires FDA-cleared chambers but is not a regulator.
Some examples of how this plays out:
- FDA-cleared chamber in a UHMS-accredited site: both credentials. Standard for hospital wound care.
- FDA-cleared chamber in a non-UHMS site: legal, common at independent clinics and wellness chains.
- Non-FDA-cleared chamber in any site: a regulatory concern, usually soft-shell wellness setups.
- Non-FDA-cleared chamber in a UHMS site: should not exist. UHMS requires FDA-cleared gear.
For deeper context on chamber clearance, read our FDA-cleared chambers complete list and our chamber-verification guide.
What accreditation does for patients
In short, UHMS accreditation tells you three things about a clinic.
The chamber is FDA-cleared. The audit requires it.
The supervising physician has formal UHM training. The audit requires either ABPM UHM board certification or equivalent CAQ.
The facility follows the UHMS Indications Manual protocols for the conditions it treats. This is the audit's central focus.
What it does not tell you: whether they take your insurance, whether they treat your condition, or whether the chamber fits your needs.
For FDA-approved uses, a UHMS-accredited site is the safe default. For off-label uses, the framework does not really apply.
The 3-year renewal cycle
UHMS accreditation expires after three years. Facilities must reapply with full re-audit to maintain the credential.
This matters for patients. A facility that was accredited five years ago but has not renewed is not currently accredited. Always check the current directory rather than trusting an old logo on the website.
Renewal failures happen. Sites lose accreditation when staffing slips, the chamber breaks, or quality issues repeat. The current directory shows active status only.
Accreditation lapses are usually quiet. Facilities do not announce them. Verifying current status takes 30 seconds in the directory.
What "Accredited with Distinction" actually requires
The "With Distinction" tier has tighter requirements. We summarize them below.
Continuous accreditation for typically 5+ years. The Distinction status is not awarded on first audit.
Above-baseline staffing. More techs per chamber. Logs of staff training.
A strong quality program. Active tracking of patient outcomes. Case-review meetings with input from multiple specialties.
Clear plans for what to do if something goes wrong. A track record of handling chamber events and oxygen-toxicity cases the right way.
The Distinction tier is not just a marketing label. It reflects facilities with demonstrated process maturity.
In practice, Distinction sites cluster at academic and large hospital systems. Memorial Hermann, Baylor, AdventHealth Orlando, and Brooke Army all hold it.
Who is not UHMS-accredited (and why)
Most US HBOT facilities are not UHMS-accredited. We will cover the main reasons.
Wellness clinics running soft-shell 1.3 ATA chambers. UHMS accreditation requires FDA-cleared hard-shell equipment. Soft-shell wellness chambers fall outside the framework.
Off-label-focused clinics. The UHMS Indications Manual is the basis for the audit. Clinics whose main practice is off-label TBI, autism, anti-aging, or long COVID do not fit the audit framework. See detailed Shamir long-COVID RCT analysis for the full Shamir-RCT methodology analysis.
Aviv Clinics in The Villages is a prominent example.
Small independent clinics. The accreditation process is expensive (typically $10,000 to $20,000 in audit fees alone, plus staff time). Many smaller clinics do not pursue it for cost reasons even when they meet the standards.
Veterinary HBOT. UHMS focuses on human medicine. Vet HBOT sites use the AAHA accreditation framework.
Lack of UHMS accreditation does not necessarily mean a clinic is unsafe. It does mean the clinic has not gone through the standardized audit process. The burden of verification shifts to the patient.
How to verify a facility's accreditation status
A 30-second check. Use the UHMS accredited facility directory on the UHMS website.
Search by state. The directory lists facility name, parent hospital, city, phone, accreditation status, and "With Distinction" flag.
If the facility appears: accredited. Note whether it's standard or Distinction.
If it does not appear: not accredited. Marketing claims without a directory match are false.
The directory updates when status changes. Lapsed sites get dropped.
International accreditation
UHMS accreditation is US-focused. Other countries have their own frameworks.
European HBOT centers can pursue ECHM accreditation. The European framework is similar to UHMS but adapted to EU rules.
UK centers can pursue accreditation through the British Hyperbaric Association. Australian centers use the SPUMS framework.
For US patients seeking care abroad — like at the Sagol Center in Israel for anti-aging research — the local accreditation framework is what counts. There is no single global HBOT standard.
How long has UHMS accreditation existed
The current accreditation program launched in 2002. UHMS itself dates to 1967.
Older HBOT facilities (1970s, 1980s, 1990s era) ran before the program existed. Some never pursued accreditation after 2002 because their habits predate the standard framework.
This is mostly a historical footnote, not a current concern. Any facility that has operated continuously since the 1990s and has not pursued UHMS accreditation in 20+ years has actively chosen not to.
Limitations of UHMS accreditation
An honest take. UHMS accreditation has real limits.
It is voluntary, so quality clinics may not pursue it and unqualified clinics certainly do not.
It is process-focused. Audits verify procedures, not outcomes. A facility can pass the audit and have poor patient outcomes if those outcomes are not captured in QA.
It does not protect against off-label drift. An accredited facility can technically treat off-label indications while remaining accredited if the audit does not catch it.
It does not standardize pricing or billing. Two accredited facilities can charge wildly different amounts for the same protocol.
It does not address the medical-vs-wellness chamber-pressure debate. The accreditation framework assumes clinical practice; it has nothing to say about 1.3 ATA wellness use.
For a deeper look at the chamber-pressure question, read our mild vs medical HBOT comparison.
Bottom line
UHMS accreditation is the most meaningful HBOT facility credential in the US. It verifies safety, staffing, equipment, and protocols through on-site audit every three years.
For FDA-approved uses, a UHMS-accredited site is the standard pick. The credential does not guarantee good outcomes, but it raises the safety floor a lot.
The credential is independent of FDA chamber clearance. Both matter. Neither is a substitute for the other.
UHMS accreditation is not universal. Most US HBOT facilities are not accredited. That does not always mean they are unsafe — but it does mean the burden of verification shifts to the patient.
Related Reading
- How to verify a clinic's chamber is medical-grade
- FDA-cleared hyperbaric chambers complete list
- Mild HBOT vs medical HBOT: why 1.3 ATA is controversial
- Best HBOT clinics in Texas 2026
- Best HBOT clinics in Florida 2026
Frequently asked questions
Is UHMS accreditation legally required?
No. UHMS accreditation is voluntary. Hyperbaric oxygen therapy is legal to operate without UHMS accreditation, provided the chamber is FDA-cleared and applicable state requirements are met.
Why aren't more clinics UHMS-accredited?
Cost (typically $10,000 to $20,000 in audit fees), staff time, and fit with practice model. Wellness clinics and off-label-focused clinics generally do not pursue UHMS accreditation because the framework does not match their practice.
Does Medicare require UHMS accreditation?
No. Medicare requires that the chamber be FDA-cleared and that the supervising physician meet credentialing requirements. UHMS accreditation is not a Medicare prerequisite, though most Medicare HBOT centers are accredited.
How is "With Distinction" different from regular accreditation?
Distinction requires above-baseline staffing, longer continuous accreditation history (typically 5+ years), and more robust quality-assurance documentation. Fewer than half of accredited facilities hold Distinction.
Can a clinic lose UHMS accreditation?
Yes. Accreditation expires after three years if not renewed. Facilities can also lose accreditation mid-cycle for major safety violations or staffing changes. Always check the current directory rather than trusting older claims.
Medical disclaimer: This guide is informational and does not constitute medical advice. HBOT carries real risks including ear barotrauma, oxygen toxicity, and chamber fire. Discuss any HBOT plan with a physician trained in undersea and hyperbaric medicine before starting. The FDA has cleared HBOT for 13 specific indications; uses outside those indications are off-label and not supported by FDA evaluation.
-- The HBOT Finder Team