TRICARE Manuals - Display Chap 8 Sect 11.1 (Change 85, Jul 7, 2021)

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Chapter 8

Section 11.1

Podiatry

Issue Date: September 20, 1990

Authority: 32 CFR 199.4(c)(2) and (g)(31)

Revision: C-83, June 2, 2021

1.0 DESCRIPTION

This section applies to services provided by a Doctor of Podiatric Medicine or a podiatrist (reference 32 CFR 199.6(c)(3)(iii)(C)). Podiatry is the specialized field that deals with the study and care of the foot, including its anatomy, pathology, medical and surgical treatment (including the ankle and lower extremity in some states).

2.0 POLICY

2.1 Podiatric services and related services, such as laboratory and radiology services, are covered.

2.2 Routine foot care service for peripheral vascular disease, metabolic or neurological disease may be covered.

2.3 Related TRICARE Policies.

• For orthotic devices and orthopedic shoes that are an integral part of a brace, see Section 3.1, paragraph 3.2.

• For therapeutic shoes, inserts and modifications for diabetics, see Section 8.2.

2.4 Effective December 17, 2020, Doctors of Podiatric Medicine or Podiatrists acting within the scope of their license may prescribe Physical Therapy (PT) and Occupational Therapy (OT).

2.5 For TRICARE Prime beneficiaries, a TRICARE network podiatrist who makes a referral to a network PT or OT provider is considered a care coordinator and no Primary Care Manager (PCM) referral is required. The podiatrist is responsible for notifying the contractor that a referral is being made. The contractor will assist the TRICARE Prime enrollee in locating a Military Treatment Facility/Enhanced Multi-Service Market (MTF/eMSM) or network provider to provide the specialty care and in scheduling an appointment. Additionally, the contractor will conduct a prospective review and authorize the service in accordance with the contractor’s best practices.

3.0 EXCLUSIONS

3.1 Removal of corns, calluses, trimming of toenails, and other routine podiatry services are excluded from coverage, unless the patient has a diagnosed systemic medical disease affecting the lower limbs.

3.2 Nerve blocks performed for the theoretical purpose of increasing blood supply to the foot and toes.

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