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Printed Date: 9/22/2015
Please Note: Requirements for diabetic footwear, inserts, or custom inserts will vary based on state laws and medical necessity. The NSC will not accept training in lieu of any state licensure requirements.
Section 1861 (s) (12) (C) of the Social Security Act states, 'the shoes are fitted and furnished by a podiatrist or other qualified individual (such as a pedorthist or orthotist, as established by the secretary).'
CMS has defined other qualified individuals in October 2008 of the DMEPOS quality standards under Appendix C. Individuals supplying the item(s) set out in this appendix must possess specialized education, training, and experience in fitting, and certification and/or licensing. This training must be within the scope of practice of complexity and thus not used in lieu of being furnished by a pedorthist, orthotist or prosthetist, as applicable.
Supplier Standard 1 states, 'A supplier must be in compliance with all applicable federal and state licensure and regulatory requirements.' Therefore, if a state requires a license to provide diabetic footwear, then the supplier will have to be properly licensed in order to provide this service to Medicare beneficiaries.
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Last Updated: 06/06/2019