Medicare's Therapeutic Shoe Bill

| Jan 1, 2000

Are you eligible?

You must have one or more of the following:

  • Peripheral neuropathy and callus formation.
  • History of pre-ulceration or ulcers with callus formation.
  • Significant foot deformity.
  • Previous amputation of a foot or part of a foot.
  • Impaired circulation.

What are covered?

  • Custom-molded shoes
  • Extra-depth shoes
  • Inserts
  • Shoe modifications

Limited to the following in one calendar year:

  • One pair of custom-molded shoes with inserts and two additional pairs of inserts or,
  • One pair of extra-depth shoes and three pairs of inserts.
  • Modifications of shoes can be substituted for a pair of inserts.

Who can furnish therapeutic shoes?

Shoes must be fitted and furnished by a podiatrist, orthotist or prosthetist. These persons must be registered with Medicare.

These specialists will fill out the appropriate prescription after the physician has completed the Certification Statement.

Certification for coverage

Special shoes must be certified by a physician who is responsible for treating the person with diabetes.

Payment and Reimbursement

The shoe supplier will file the appropriate claim form to Medicare. Payment is made directly to the supplier or to the patient.

Reimbursement is limited to 80 percent of the reasonable charge and there is a maximum amount that Medicare will reimburse.

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Categories: Diabetes, Foot Care, Health Insurance


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