Yes, Medicare does pay for podiatric care, primarily through Medicare Part B, when the services are considered medically necessary. This coverage extends to the diagnosis and treatment of specific foot conditions that affect your health.
How Medicare Part B Covers Podiatric Services
Medicare Part B covers podiatry services when they are medically necessary for the treatment of foot injuries, diseases, or other medical conditions affecting the foot, ankle, or lower leg. This means that if you have a foot problem directly related to a medical condition that requires professional intervention, Medicare Part B will typically help cover the costs.Common Podiatric Services Covered by Medicare
Medicare Part B covers a range of medically necessary podiatric services, including:- Diagnosis and Treatment of Foot Conditions: This includes conditions like bunions, hammer toes, heel spurs, neuromas, and arthritis affecting the feet.
- Treatment of Nerve Damage or Circulatory Issues: For instance, Medicare covers routine foot care if you have diabetes or other conditions that cause nerve damage (diabetic peripheral neuropathy) or poor circulation, making self-care dangerous. This often involves specific examinations and treatment of foot ulcers, infections, or other complications.
- Surgical Procedures: Medically necessary surgeries on the foot, ankle, or lower leg performed by a podiatrist or other qualified doctor.
- Treatment of Injuries: Care for fractures, sprains, or other acute injuries to the foot or ankle.
- Infections and Ulcers: Treatment for infections, ingrown toenails (when they are a medical issue), or foot ulcers that require professional care.
What is "Medically Necessary" Podiatric Care?
Medically necessary care refers to services or supplies that are needed for the diagnosis or treatment of a medical condition, injury, or illness, and meet accepted standards of medical practice. For podiatry, this distinguishes care for specific health problems from routine personal care.What Medicare Does Not Typically Cover
While Medicare Part B covers medically necessary podiatric care, it generally **does not cover routine foot care**. This typically includes:- The cutting or removal of corns and calluses
- The trimming, cutting, or clipping of nails
- Hygienic care, such as cleaning and soaking the feet
These services are usually only covered if they are an integral part of medically necessary treatment for a foot injury, disease, or medical condition, especially for individuals with severe medical conditions like diabetes that put them at risk for complications from routine foot care.
Understanding Your Costs
If Medicare Part B covers your podiatric services, you will typically pay:- The Medicare Part B deductible (if you haven't already met it for the year).
- 20% of the Medicare-approved amount for the doctor's services, after you meet the deductible.
- Any additional costs for facility fees if the service is performed in an outpatient hospital setting.
