Additional cost incurred by fitting (I assume Medicare) patient with two different size shoes cannot be passed onto patient (assuming that you accept assignment). If you do not accept Medicare assignment you can charge patient whatever you want such that increased cost is borne by patient. Less significant differences in foot size (especially in width) can sometime be accommodated with the same size shoe by removing spacers from the larger foot and adding spacers to the smaller foot. domain search availability Alternative, if size is significant enough is to cast patient for custom molded shoes.
Josh White, DPM, CPed