Medicare and Foot Care: What Is and Isn't Covered
What Medicare Part B covers for foot care, why routine foot care usually isn't covered, the exceptions, and the rules for diabetic foot exams and shoes.
Many people are surprised to learn that Original Medicare does not usually pay for routine foot care, such as having toenails trimmed. It does pay for medically necessary foot care, and it has special rules for people with diabetes. This guide sums up what Medicare's official pages say, as of October 2026, and lists questions to ask before a visit. Coverage decisions are made by Medicare and your plan, not by this directory, so always confirm the details for your own case.
What Medicare Part B covers
According to Medicare's foot care coverage page, Part B covers foot exams or treatment by a podiatrist when the treatment is medically necessary for a foot injury or disease. Medicare gives hammer toe, bunion deformities and heel spurs as examples.
For these covered services, Medicare says you pay 20% of the Medicare-approved amount after you meet the Part B deductible. If the care is given in a hospital outpatient setting, a copayment also applies. Medicare notes that what you actually pay depends on other insurance, what the doctor charges, whether the doctor accepts assignment, the type of facility and where you get the service.
What "routine foot care" means, and why it is usually not covered
Medicare says it does not usually cover routine foot care. Its examples are cutting or removing corns and calluses, trimming or clipping nails, and hygiene or other preventive maintenance, such as cleaning and soaking the feet. If you get a service Medicare does not cover, you pay all of the cost.
The rules Medicare contractors follow are set out in chapter 15, section 290 of the Medicare Benefit Policy Manual. That section also says that treatment of flat foot, and supportive devices for the feet such as orthopedic shoes, are generally not covered. The manual makes two exceptions to the shoe rule: a shoe that is an integral part of a leg brace, and therapeutic shoes for people with diabetes.
The exceptions
Medicare's consumer page says that in very limited circumstances it may cover routine foot care. The Benefit Policy Manual explains what those circumstances are. In plain terms:
- A systemic condition. Some conditions affect circulation or feeling in the legs and feet. The manual names metabolic, neurologic and peripheral vascular diseases, with diabetes among the examples. When such a condition causes severe circulation problems or reduced feeling in the legs or feet, care that would otherwise be routine may be covered, because doing it at home could be risky. For several of the listed conditions, including diabetes, the manual says the person must be under the active care of an MD or DO who documents the condition.
- Part of other covered care. Routine-type care may be covered when it is a necessary part of treating something covered, such as an ulcer, a wound or an infection.
- Warts. Treatment of warts on the foot, including plantar warts, is covered the same way as treatment of warts elsewhere on the body.
- Fungal toenails. Treatment of mycotic (fungal) nails may be covered when the treating doctor documents the infection plus certain problems it causes, such as pain, secondary infection or, for people who can walk, marked limits on walking.
These exceptions depend on findings and records that only your clinician can provide. Ask the office whether it expects the service to be covered, and why.
Foot care for people with diabetes
Medicare has a separate page on foot care for diabetes. It says Part B covers foot exams or treatment if you have diabetes-related nerve damage in the lower legs that raises the risk of losing a limb. To qualify, you must have diabetic peripheral neuropathy with loss of protective sensation. Medicare covers an exam every six months, as long as you have not seen a foot care professional for another reason between visits. The usual Part B deductible and 20% coinsurance apply.
Therapeutic shoes and inserts
Medicare's page on therapeutic shoes and inserts says Part B covers them for people who have diabetes and severe diabetes-related foot disease. Each calendar year, Medicare says it covers one of these:
- one pair of custom-molded shoes and inserts, plus two more pairs of inserts, for people who cannot wear depth-inlay shoes because of a foot deformity; or
- one pair of extra-depth shoes, plus three pairs of inserts.
Medicare may also cover shoe modifications instead of inserts. The doctor who treats your diabetes must certify the need. A podiatrist or other qualified doctor must prescribe the shoes, and a podiatrist, orthotist, prosthetist, pedorthist or other qualified person must supply them. Medicare stresses that it only covers the shoes if both the doctors and the supplier are enrolled in Medicare.
Assignment, and why it matters
Medicare explains on its assignment page that a provider who accepts assignment agrees to take the Medicare-approved amount as full payment and to charge you only the deductible and coinsurance. A provider who is enrolled but does not accept assignment can charge more than the approved amount. Medicare says that in many cases the charge cannot be more than 15% above the approved amount. A provider who has opted out of Medicare is paid nothing by Medicare except in emergencies, and you pay under a private contract.
Listings in this directory show, where CMS data is available, whether a podiatrist is enrolled in Medicare and whether he or she accepts assignment. This data comes from a federal file and can lag behind real changes. Confirm with the office when you book. The directory does not show prices or say which Medicare Advantage or other plans a podiatrist takes.
Second opinions before surgery
If a podiatrist or surgeon recommends non-emergency foot or ankle surgery, Medicare says Part B covers a second surgical opinion, and a third if the first two differ. The usual deductible and coinsurance apply. Our guide to podiatrists and orthopedic foot and ankle surgeons has questions to ask before surgery.
Questions to ask the office
- Are you enrolled in Medicare, and do you accept assignment?
- Do you expect this service to be covered? If not, will you tell me before you do it?
- If I have Medicare Advantage or other coverage, do you work with my plan?
- For therapeutic shoes, is the supplier enrolled in Medicare, and who certifies my need?
- For diabetic foot exams, what does my record show about nerve damage and loss of feeling?
For more on how diabetes affects the feet, see our diabetes and foot health guide.
General information only, current as of the date above. The information on Podiatrist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.