Title 907 | Chapter 001 | Regulation 270
907 KAR 1:270.Podiatry Program services.
Section 1.
Coverage. The Medicaid program shall cover a medical or surgical service provided to an eligible Medicaid recipient by a licensed, participating podiatrist if the service falls within the scope of the practice of podiatry except as provided in Section 2 of this administrative regulation.Section 2.
Exclusions From Coverage.(1)
Except as provided in Section 3 of this administrative regulation, routine foot care shall not be covered by the Medicaid program.(2)
Routine foot care excluded by this section shall include:(a)
The cutting or removal of a corn or callus;(b)
The trimming of a nail; or(c)
Other hygienic or preventive maintenance care in the realm of self-care including:1.
Cleaning or soaking a foot;2.
The use of a skin cream to maintain skin tone of an ambulatory or bedfast patient; or3.
A service performed in the absence of localized illness, injury, or symptom involving the foot.Section 3.
Covered Services.(1)
(a)
Payment shall be made for routine foot care if:1.
The patient has a systematic disease of sufficient severity such as arteriosclerosis, chronic thrombophlebitis, diabetes, or a peripheral neuropathy;2.
Unskilled performance of a procedure included in paragraph (b) of this subsection would be hazardous; and3.
The patient's condition results from:a.
Severe circulatory embarrassment; orb.
An area of desensitization in a leg or foot.(b)
Routine foot care covered under this subsection shall include the cutting or removing of a:1.
Corn;2.
Callus; or3.
Nail.(2)
A service ordinarily considered routine shall be covered if the service is performed as a necessary and integral part of an otherwise covered service, including the diagnosis or treatment of:(a)
A diabetic ulcer;(b)
A wound; or(c)
An infection.(3)
A diagnostic or treatment service for a foot infection shall be covered.HISTORY: (Recodified from 904 KAR 1:270, 5-2-1986; 18 Ky.R. 1647; eff. 1-10-1992; 23 Ky.R. 4241; 24 Ky.R. 385; eff. 7-16-1997; 45 Ky.R. 2212, 2684; eff. 4-5-2019.)
907 KAR 1:270.Podiatry Program services.
Section 1.
Coverage. The Medicaid program shall cover a medical or surgical service provided to an eligible Medicaid recipient by a licensed, participating podiatrist if the service falls within the scope of the practice of podiatry except as provided in Section 2 of this administrative regulation.Section 2.
Exclusions From Coverage.(1)
Except as provided in Section 3 of this administrative regulation, routine foot care shall not be covered by the Medicaid program.(2)
Routine foot care excluded by this section shall include:(a)
The cutting or removal of a corn or callus;(b)
The trimming of a nail; or(c)
Other hygienic or preventive maintenance care in the realm of self-care including:1.
Cleaning or soaking a foot;2.
The use of a skin cream to maintain skin tone of an ambulatory or bedfast patient; or3.
A service performed in the absence of localized illness, injury, or symptom involving the foot.Section 3.
Covered Services.(1)
(a)
Payment shall be made for routine foot care if:1.
The patient has a systematic disease of sufficient severity such as arteriosclerosis, chronic thrombophlebitis, diabetes, or a peripheral neuropathy;2.
Unskilled performance of a procedure included in paragraph (b) of this subsection would be hazardous; and3.
The patient's condition results from:a.
Severe circulatory embarrassment; orb.
An area of desensitization in a leg or foot.(b)
Routine foot care covered under this subsection shall include the cutting or removing of a:1.
Corn;2.
Callus; or3.
Nail.(2)
A service ordinarily considered routine shall be covered if the service is performed as a necessary and integral part of an otherwise covered service, including the diagnosis or treatment of:(a)
A diabetic ulcer;(b)
A wound; or(c)
An infection.(3)
A diagnostic or treatment service for a foot infection shall be covered.HISTORY: (Recodified from 904 KAR 1:270, 5-2-1986; 18 Ky.R. 1647; eff. 1-10-1992; 23 Ky.R. 4241; 24 Ky.R. 385; eff. 7-16-1997; 45 Ky.R. 2212, 2684; eff. 4-5-2019.)