13-005 Code Vt. R. 13-174-005-X

Current through August, 2024

Section 13 174 005 - PODIATRY SERVICES

4.221 Podiatry Services.

(5/1/2023, GCR 22-099)

4.221.1 Definitions

(a) "Podiatry services" means the diagnosis and treatment of ailments of the foot, ankle, and lower extremity.

4.221.2 Covered Services

(a) Vermont Medicaid covers medically necessary podiatry services.

(b) Routine foot care, including the cutting or removing of corns and calluses, and trimming, cutting, clipping, or debriding of toenails, is covered when medically necessary for beneficiaries who have a medical condition, including diabetes or a peripheral vascular disease, that affects the lower extremities.

4.221.3 Qualified Providers

(a) Podiatry services are covered when performed by a licensed podiatrist, or other licensed providers, working within their scope of practice.

4.221.4 Non-Covered Services

(a) Hygienic care including cleaning or soaking of feet is not covered.

(b) Services performed in the absence of a medical condition or injury involving the foot, ankle, or lower extremity are not covered.

(c) Routine foot care services are not covered, except as provided at HCAR 4.221.2(b), even if the individual is unable to perform these services for themself.

13-005 Code Vt. R. 13-174-005-X

EFFECTIVE DATE:
December 1, 1980 Secretary of State Rule Log #80-123
AMENDED:
October 1, 2008 Secretary of State Rule Log #08-040; 5/1/2023 Secretary of State Rule Log #23-007

STATUTORY AUTHORITY:

3 V.S.A. § 801; 33 V.S.A. § 1901