April 2021

NPs, PAs Can Certify the Medical Need for Diabetic Shoes in Limited Circumstances

The Centers for Medicare & Medicaid Services (CMS) has recently provided guidance to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) that allows nurse practitioners (NPs) and physician assistants (PAs) to certify the medical need for diabetic shoes when all of the following conditions are met:

  1. The supervising physician has documented in the medical record that the patient is diabetic and has been, and continues to provide, the patient follow-up under a comprehensive management program of that condition; and,
  2. The NP or PA certifies that the provision of the therapeutic shoes is part of the comprehensive treatment plan being provided to the patient; and,
  3. The supervising physician must review and verify (sign and date) all of the NP or PA notes in the medical record pertaining to the provision of the therapeutic shoes and inserts, acknowledging their agreement with the actions of the NP or PA.

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