Hyperbaric oxygen therapy is administered by a multidisciplinary team, not a single provider. A physician prescribes and oversees each treatment, while certified technologists, registered nurses, and sometimes respiratory therapists operate the chamber and manage patient care during sessions. The specific roles and credentials required depend on whether the facility is hospital-based or freestanding, but every hyperbaric program needs a qualified physician, trained chamber operators, and a designated safety coordinator.
The Physician’s Role
A licensed physician (MD or DO) must order hyperbaric oxygen therapy and supervise treatments. Physicians don’t typically sit at the chamber controls during every session, but they are responsible for evaluating patients, determining whether hyperbaric therapy is appropriate, and being available to intervene if complications arise. Medicare requires direct physician supervision for hyperbaric treatments it covers, meaning a qualified doctor must be immediately available on-site while the chamber is in use.
Physicians who specialize in hyperbaric medicine can pursue board certification through organizations like the American Board of Wound Healing. To qualify, a physician needs an active U.S. medical license, completion of an approved training program or fellowship (through the Undersea and Hyperbaric Medical Society, the American College of Hyperbaric Medicine, or the U.S. Department of Defense), and documented supervision of at least 300 hyperbaric patient treatments within the preceding two years. Hyperbaric certification is open to physicians across multiple specialties, from emergency medicine to wound care to pulmonology, so there’s no single “type” of doctor who runs these programs.
Certified Hyperbaric Technologists
The people most often operating the chamber itself are Certified Hyperbaric Technologists (CHTs). These are the hands-on staff who pressurize and depressurize the chamber, monitor patients through viewports or communication systems, and manage the equipment throughout each session. The CHT credential is granted by the National Board of Diving and Hyperbaric Medical Technology (NBDHMT) after candidates complete a formal, accredited training program in hyperbaric technology, finish a clinical preceptorship, and pass a certification exam.
Staying certified isn’t a one-time achievement. CHTs must recertify every two years by completing at least 24 continuing education hours (with a minimum of 12 in the highest-priority clinical category), logging at least 100 clinical work hours, and paying a recertification fee. This structure ensures technologists stay current with evolving safety standards and equipment.
Registered Nurses in Hyperbaric Medicine
Registered nurses play a central role in hyperbaric programs, particularly in hospital-based facilities. They assess patients before and after treatments, monitor vital signs, manage wounds, and coordinate care with the supervising physician. Nurses who want to specialize can earn the Certified Hyperbaric Registered Nurse (CHRN) credential, also through the NBDHMT.
The pathway to CHRN certification starts with completing an NBDHMT-accredited introductory hyperbaric medicine course. The certification exam itself reflects the dual nature of the role: roughly 40% of questions focus on nursing-specific activities like patient assessment and care management, while the remaining 60% covers the technical, safety, and operational knowledge shared with other hyperbaric staff. This balance means hyperbaric nurses need to understand both the clinical side and the physics of pressurized environments.
Respiratory Therapists
Respiratory therapists have become increasingly involved in hyperbaric medicine, and some facilities rely on them as primary chamber operators. Their background in gas physics, oxygen delivery systems, and pulmonary function gives them a natural advantage in the hyperbaric environment, where understanding how gases behave under pressure is essential. The Undersea and Hyperbaric Medical Society has recognized this role since 1985 through a dedicated Associate Section for allied health professionals, including respiratory therapists.
At some centers, respiratory therapists also handle diagnostic testing that’s critical to tracking patient outcomes, such as transcutaneous oxygen monitoring. Their existing training in troubleshooting oxygen delivery equipment and managing airway emergencies translates directly to hyperbaric work. While the number of respiratory therapists formally credentialed in hyperbaric medicine remains relatively small compared to CHTs and CHRNs, their presence in hyperbaric programs continues to grow.
The Hyperbaric Safety Coordinator
Every hyperbaric facility is required to designate a hyperbaric safety coordinator under NFPA 99, the national fire safety code that governs healthcare facilities. This person is responsible for all hyperbaric equipment and the operational safety requirements of the program. The title varies from facility to facility (safety director, hyperbaric safety director, hyperbaric safety coordinator), but the NFPA’s intent is the same regardless of terminology: someone must own the safety program.
The safety coordinator oversees mock fire drills with all department staff, ensures emergency procedures are current, and provides leadership and safety training to other hyperbaric personnel. This role can be filled by a physician, technologist, nurse, or other qualified staff member, as long as they have comprehensive training in hyperbaric safety protocols. In smaller freestanding clinics, the safety coordinator may also serve as the primary chamber operator.
Hospital vs. Freestanding Clinic Staffing
Staffing requirements differ between hospital-affiliated hyperbaric programs and independent clinics. Hospital-based facilities typically credential their hyperbaric physicians through the hospital’s medical staff office, with formal credentialing policies and privileging processes. They also tend to have larger teams with dedicated nurses, technologists, and support staff.
Freestanding hyperbaric centers face the same core requirements (physician supervision, trained operators, a safety coordinator) but may operate with leaner teams. Facility accreditation through the NBDHMT evaluates staffing patterns, personnel qualifications, certification levels, new employee orientation, staff competencies, and continuing education logs. Whether a center is inside a hospital or in a standalone building, accreditation reviewers look for the same evidence that every person touching patient care has the right training and credentials to do so safely.
What This Means for Patients
If you’re considering hyperbaric oxygen therapy, the credentials of the team matter. A well-run program will have a physician with documented hyperbaric training (ideally board-certified), chamber operators who hold current CHT or CHRN certification, and a designated safety coordinator. You can ask any facility whether their staff holds NBDHMT credentials and whether the program follows UHMS clinical practice guidelines. Facilities that pursue voluntary accreditation are signaling that they’ve submitted to an outside review of their staffing, training, and safety practices, which provides an extra layer of accountability.