- Special therapeutic shoes, inserts and modifications can be covered for diabetic patients with the following foot conditions: • previous amputation of a foot or partial foot
- history of foot ulceration or pre-ulcerative calluses
- peripheral neuropathy with callus formation
- foot deformity
- poor circulation in either foot
- You must have an office visit with your physician or healthcare provider within six months of receiving new shoes to discuss and document your diabetes management and why you need these special shoes. This office visit must be repeated each time you wish to obtain replacement shoes.
- Only a physician treating your diabetes can certify your diabetic condition and complications that require specialty shoes.
- Your healthcare practitioner or a podiatrist may further evaluate your feet and order the shoes.
- When providing you with shoes, your supplier must perform an in-person evaluation of your foot/feet, and they must verify that your shoes fit properly.
- Newly established requirements of the Affordable Care Act require a specific office visit with your physician or healthcare practitioner to assess and document your need for this equipment take place and must then issue a compliant written order.
- Your supplier cannot deliver this product to you without a written order from your doctor or healthcare provider. If the equipment is subject to these special rules, your supplier cannot get the documentation at a later date because if they do, Medicare can never make payment for those products to you or your supplier when a compliant order is not secured before delivery. So please be patient with your supplier while they collect the required documentation from your physician or healthcare provider.