Good news!! On January 1, 2015, the Medicare fee schedule for diabetic shoes, Moore Balance Brace and Arizona custom AFOs increased. While the amount reimbursed by each DME MAC may vary slightly, the National Fee Schedule allowables are as follows:
Depth Shoes (A5500) $141.14
Prefabricated, Heat Molded Inserts (A5512) $57.58
Custom Molded Inserts (A5513) $85.92
Depth Shoes w/ 3 pr. Prefab, Heat Molded Inserts $313.88
Depth Shoes w/ 3 pr. Custom Molded Inserts $398.90
Custom Molded Shoes w/ Custom Molded Inserts $586.42
Arizona AFO, Standard (L1940, L2330, L2820) $1162.23
Moore Balance Brace (L1940, L2330, L2820) $1162.23
For a complete listing of updated DME prices, including prefabricated and custom ankle foot orthoses, go to:
In 2011, many podiatrists were audited by Medicare and had to refund money because rules had changed and many were not aware of the documentation required to fit diabetic shoes.
As one famous retailer once said, “An educated consumer is our best customer”. In that spirit I have acquired one of the world’s largest collections of audit letters relating to the Medicare therapeutic shoe program. Examples are displayed in the “Library” section on the SafeStep website, accessible only after logging in.
When podiatrists have failed shoe audits, the vast majority of times it has been for :
- Failure to demonstrate that the primary care physician has documented a qualifying foot condition and has had an in-person visit with the patient during which diabetes management is addressed within 6 months prior to the patient receiving shoes.
Even when podiatrists have figured out what they need to do to be complaint, the effort required to fill out the necessary forms and the time required to repeatedly fax these forms to the primary care physician and to be assured that the patient had a visit in the proceeding 6 months is so onerous that it might hardly seem worth the effort.
Guess what? There is a convenient way to assure Medicare compliance when fitting shoes and it’s called, “WorryFree DME”.
Here are the steps:
- Identify patients with Medicare and diabetes.
- Evaluate patients and determine qualifying conditions for therapeutic shoes.
- Select appropriate footwear.
- Fill out SafeStep information collection form.
- Enter required information into SafeStep website.
You are done! SafeStep takes over!
- SafeStep creates the Statement of Certifying Physician for Therapeutic Shoes.
- SafeStep creates the documentation required to be in the patient’s file of the primary care physician.
- SafeStep assures that patient was seen by primary care physician not more than 6 months prior to being fit with shoes.
- SafeStep faxes the forms, as though from the podiatrist for up to 3 weeks to get required signatures and dates.
Without any more work on your part:
- SafeStep sends you the signed and dated documents.
- SafeStep ships you the shoes.
Don’t let fear of Medicare audits nor the effort required to be compliant stop you from providing important care to your patients and creating revenue for your practice.
Use WorryFree DME to fit your patients conveniently and compliantly.
To learn more, go to SafeStep.net and register for a free 45 minute webinar on how to get started.