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Does Medicare cover podiatry survice if I am in a nursing home?

1 answer | Last updated: Jul 19, 2014
An anonymous caregiver asked...
Does Medicare cover podiatry survice if I am in a nursing home?

Caring.com User - Joseph L.  Matthews
Caring.com Expert
Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
33% helpful

Medicare Part B medical insurancecan cover podiatry services regardless of where you live. And the covered services can be provided in a podiatrist's office, in an outpatient clinic, or See also:
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in the nursing home itself if there is a podiatrist who visits the facility.

But the more difficult question is what podiatry services are covered by Medicare Part B. The basic Medicare coverage rule is that foot care by a podiatrist must be "medically necessary." That means, it must be care to treat a disease, injury or health condition of the foot. Medicare Part B does NOT cover routine foot care by a podiatrist, such as basic nail care or clipping, unless it is part of medically necessary treatment for a disease or condition. If you receive Medicare-covered foot care from a podiatrist for a disease or a disease-related condition, however, basic nail care might be included.

Getting Medicare coverage for care from a podiatrist depends entirely on having a medical condition as verified by a medical doctor (M.D.) or osteopath (O.D.). If Medicare approves podiatry care, it can be provided at regular intervals, but the care must be reviewed and prescribed by a physician every six months or so. Be aware that if the podiatry treatment is not clearly related to an ongoing medical condition, Medicare might refuse to cover it, particularly if it is regularly repeated care.


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