Shoes & Inserts

Cornell Orthotics & Prosthetics provides shoes and inserts for persons with diabetes under the Therapeutic Shoe Program.  Medicare developed this program as a prophylactic benefit to care for beneficiaries with foot problems related to their diabetes.

The coverage is federally mandated for all insurances. It is intended to reduce the incidence of preventable foot ulcers, infections and amputations. Medicare believes that this program will not only improve persons with diabetes’ quality of life but also will lower healthcare costs over time.  As such this program is strictly regulated to avoid fraud and abuse.  Follow the links to your insurance to understand the requirements and conditions for coverage of this benefit.

What is covered?

Coverage is limited to one of the following within 1 calendar year:

• One pair of custom molded shoes (A5501) (which includes inserts provided with these shoes) and 2 additional pairs of inserts (A5512 or A5513); or
• One pair of depth shoes (A5500) and 3 pairs of inserts (A5512 or A5513) (not including the non-customized removable inserts provided with such shoes).

What you, the beneficiary, need to do?
At your initial appointment:

• Bring your insurance information so it can be verified.
• You will be asked to complete a patient registration form.
• You will be evaluated by our pedorthist for your shoes and inserts.
• You will be measured and choose a shoe model.
• You may have impressions made of your feet.
• You will be provided an evaluation for you to take to your physician.
• You will be provided the appropriate documentation for your physician with instructions for completing it.  This may be partially completed by COP staff but must be completed, signed and dated by your physician.
• You will receive a financial responsibility letter explaining who will be billed and listing any patient balance due which must be paid in full at time of delivery..
• A copy of the Medicare supplier standards will be made available as well as the COP HIPAA policy.
• Until COP staff has received and reviewed both your Physician’s documentation for completeness no further action will be taken by COP.

After COP receives and reviews the documentation and determines its completeness a fitting appointment will be made where you will receive your prescribed items.

At your fitting appointment:

•  Be prepared to pay any monies due. Bring cash, Checks  MasterCard, Visa or Discover card.
•  You will be fitted to the prescribed items, instructed on proper use and wearing schedules and checked for proper function.
•  You will be asked to sign a proof of delivery form
•  Follow up appointments are made on an as needed basis.