to receive diabetic shoes as part of your diabetes management plan. Please click on the BUTTON below to print off the required documentation needed per the Medicare Therapeutic Shoe Bill. Below is a list of the required information needed before you are eligible to be fitted for diabetic shoes.
Statement of Certifying Physician - Signed via MD or DOonly
Prescription signed and dated for Diabetic Shoes and Inserts by - DPM, MD, DO, PA NP or CNS who performed the Foot Exam
Diabetes Management Exam Note - Signed and dated by MD or DO only within the last 6 months.
