Clarifying Medicare documentation requirements for therapeutic shoes for persons with diabetes

(a) In general Section 1861(s)(12) of the Social Security Act (42 U.S.C. 1395x(s)(12)) is amended to read as follows: (12) extra-depth shoes with inserts or custom molded shoes with inserts for an individual with diabetes, if— (A) a physician as defined in subsection (r) of this section— (i) documents that the individual has peripheral neuropathy that may include altered foot sensation, weakness, or diminished motor control of the lower extremity; a history of pre-ulcerative calluses or other ulceration of the foot; foot deformity, previous lower extremity amputation, or poor lower extremity circulation; (ii) attests that the individual has a diabetes diagnosis and is under a comprehensive plan of care related to the individual’s diabetic condition; and (iii) attests that the individual needs such shoes; and (B) the shoes are fitted and furnished by a physician or other qualified individual (such as a pedorthist or orthotist) as established by the Secretary;. (b) Conforming amendment Section 1877(h)(6) of the Social Security Act (42 U.S.C. § 1395nn(h)(6)) is amended by inserting after subparagraph (L) the following: (M) Extra-depth shoes with inserts or custom molded shoes with inserts.. (c) Effective date The amendment made by subsection (a) shall apply with respect to items and services furnished on or after January 1, 2028.