The American College of Hyperbaric Medicine (ACHM) is aware of recent correspondence issued by the
National Board of Diving & Hyperbaric Medical Technology (NBDHMT) referencing a purported “5-minute
response time” standard for hospital-based hyperbaric medicine programs. The communication further
implied that Certified Hyperbaric Technologist (CHT) credentials may be at risk if institutions fail to comply
with this expectation.
The ACHM wishes to reaffirm that the NBDHMT functions as a certifying organization within the hyperbaric
field, not as a regulatory agency or an authority having jurisdiction over hospital operations. While the
ACHM values the NBDHMT’s longstanding contribution to professional education and credentialing, it does
not possess statutory or enforcement authority to dictate operational or supervision standards within
healthcare institutions.
It is also important to emphasize that the Centers for Medicare & Medicaid Services (CMS) revised
supervision requirements for hyperbaric oxygen (HBO₂) therapy in January 2020, transitioning from direct to
general supervision under the Physician Fee Schedule. The ACHM continues to advocate that direct
supervision remains the gold standard for ensuring patient safety, and many centers voluntarily uphold this
practice. Nevertheless, each facility is responsible for defining and maintaining its own HBO₂ supervision
and physician response parameters in alignment with CMS regulations, hospital policies, and medical staff
governance. The concept of a universal “5-minute” response rule is not part of CMS policy and should not be
construed as a federally or regulatory mandated standard.
Many institutions appropriately define physician availability with terms such as “readily accessible,”
“immediately available,” or “not concurrently scrubbed,” rather than by an arbitrary time frame. These
individualized policies remain compliant when consistent with CMS definitions and institutional bylaws.
The ACHM reaffirms that hyperbaric programs and operators—regardless of certification status—must
function within their institution’s approved safety and supervision framework. Providers and technologists
share responsibility for confirming that supervising clinicians meet established availability standards prior to
treatment initiation. However, it is outside the operator’s role or authority to enforce requirements beyond
what is formally adopted by their hospital or health system. No provider or technologist should face threats to
their certification or professional standing when adhering to approved institutional policy and current CMS
guidelines.
Respectfully
Tyler Sexton, MD, MAPWCA
President, American College of Hyperbaric Medicine
