Helping Your Provider Prescribe You the Right Orthopedic Footwear

If you’re experiencing foot pain, have a partial foot amputation, or need specialized shoes to support your mobility, Medicare may help cover the cost of orthopedic footwear. But first, your healthcare provider must prescribe it the right way.

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Here’s how to talk to your provider — and what they’ll need to do.


Step 1: Confirm You Might Be Eligible

Medicare only covers orthopedic footwear when it's medically necessary. That means the shoes must be prescribed to help with one of the following:

Tip: Your provider must include a diagnosis code that supports this need. Medicare will deny claims if the diagnosis doesn’t match their approved list.


Step 2: Ask for a Standard Written Order (SWO)

Before your shoes can be delivered or billed to Medicare, your provider must write a Standard Written Order (SWO) and send it to the supplier. The order must include:

Without this order, Medicare will deny the claim.


Step 3: Make Sure Your Provider Documents Medical Necessity

In addition to writing the order, your provider must document in your medical record:

If this information isn’t in your record, your claim can still be denied, even with a valid order.


Step 4: Work with a Medicare-Approved Supplier

The supplier must:


What Codes Might Be Used?

Your provider or supplier may use any of these common HCPCS codes:

Tip: Ask your provider which code they are using — and make sure it’s listed on the order.


Recap: What to Ask Your Provider

Here’s a simple script you can use:

“I’m having trouble walking and think I may benefit from orthopedic footwear. I understand Medicare may cover it if it’s medically necessary. Could you help me with a Standard Written Order and make sure my diagnosis and the medical need are documented in my records?”


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