See How Nurse Practitioners (NP) and Physician Assistants (PA) Qualify as Certifying Physicians for Therapeutic Shoes and Inserts

NPs and PAs who are practicing under the supervision of an MD or DO (i.e., “incident to”) as the certifying physician can provide therapeutic shoes to beneficiaries with diabetes if certain criteria are met:

  • 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,
  • The NP or PA certifies that the therapeutic shoes are part of the comprehensive treatment plan being provided to the patient; and,
  • The supervising physician must review and verify (sign and date) all the NP or PA notes in the medical record concerning the provision of the therapeutic shoes and inserts, and must acknowledge their agreement with the actions of the NP or PA.

In states where the NP may practice independently, they must still comply with these rules to serve as the certifying physician for Medicare. You can refer to Policy Article A52501 and the applicable A/B MAC for more information.


Last Updated Mar 21 , 2022