How often will Medicare cover podiatry office visits?

1 answer | Last updated: Oct 14, 2016
A fellow caregiver asked...

How often will Medicare cover podiatry office visits? My father gets his nails clipped there.I am hearing conflicting information from a podiatry office and the nursing director of my dad's assisted living facility.


Expert Answers

Medicare Part B medical insurance does not have a how-many-times-per-month or how-many-times-per-year rule about covering podiatry services. Medicare's basic rule about foot care by a podiatrist is that the care must be medically necessary, which means that it must be care for a disease or injury, or for a disease-related condition. Medicare Part B does NOT cover routine foot care by a podiatrist, such as simple nail clipping, unless it is part of medically necessary treatment for a disease or condition. In other words, if someone is getting Medicare-covered regular foot care from a podiatrist for a disease or a disease-related condition, nail clipping might be included.

So, how often your father can get Medicare coverage for care from a podiatrist depends entirely on whether he has a medical condition that requires such care, and on how often that medical condition must be treated. Whether he has such a medical condition usually has to be verified by a medical doctor (M.D.) or osteopath (O.D.). If Medicare approves treatment by a podiatrist, that treatment can be provided at regular intervals as decided by the podiatrist, but the care must be reviewed and prescribed by a physician every six months or so. And there is always the chance that Medicare will challenge regular treatment by a podiatrist if the treatment is not clearly related to an ongoing medical condition.