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; or

3.

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; and

3.

The patient's condition results from:

a.

Severe circulatory embarrassment; or

b.

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; or

3.

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.)

7-Year Expiration: 4/5/2026

Last Updated: 12/15/2021


Page Generated: 8/19/2022, 12:42:07 PM