Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
Quick answer: Diabetic foot care is essential for preventing ulcers, infections, and amputations. Our Michigan podiatrists perform thorough diabetic foot exams, monitor circulation and nerve function, and provide personalized care plans — catching and treating problems early before they become serious complications.
Treatment at Balance Foot & Ankle: Diabetic Foot & Circulation Screening →
| Eligibility Criterion | Requirement | Documentation Needed | Notes |
|---|---|---|---|
| Diagnosis of Diabetes Mellitus | Any type (Type 1 or Type 2); ICD-10 coded visit | Treating physician (MD/DO/NP/PA) certifies diabetes diagnosis | Must be documented in the plan of care for diabetes |
| One of 5 High-Risk Foot Conditions | Peripheral neuropathy with callus; history of pre-ulcerative callus; history of foot ulceration; foot deformity; previous amputation | Podiatrist or treating physician documents condition in medical record | Most Medicare diabetics qualify via neuropathy + callus |
| Enrolled in Medicare Part B | Part B coverage required | Medicare card; Part B active | Medicare Advantage plans typically follow same coverage rules |
| Prescription from Treating Physician | MD/DO/NP/PA who manages diabetes (not the podiatrist) signs CMN/order | Certificate of Medical Necessity (CMN) or written order with diagnosis and medical necessity statement | Podiatrist CANNOT be both the prescriber and the fitting provider (anti-markup rule) |
| Annual Benefit (calendar year) | 1 pair custom-molded shoes OR 1 pair depth-inlay shoes + 3 pairs custom inserts per calendar year | Documentation of fitting by qualified pedorthist, orthotist, or podiatrist | Resets January 1 each calendar year |
| Feature | Custom-Molded Shoes | Depth-Inlay Shoes + Custom Inserts | Standard OTC Diabetic Shoe |
|---|---|---|---|
| Indication | Severe foot deformity; Charcot foot; prior amputation; orthotics won’t fit in depth shoe | Mild-moderate deformity; neuropathy; standard diabetic foot risk | Mild risk; no Medicare benefit; self-pay |
| Fabrication | Plaster or 3D scan of foot; custom last; individual construction | Off-the-shelf shoe with extra depth (3/8″ to 1/2″) + custom-molded multi-density insert | Generic extra-wide; no custom component |
| Medicare Coverage | Covered (A5501); higher allowable (~$400–$600/pair) | Covered (A5500 shoe + A5512/A5513 inserts) | Not covered under therapeutic shoe benefit |
| Pressure Distribution | Maximum offloading; total contact inside shoe | Excellent with properly made insert; 60–70% pressure reduction at high-risk zones | Minimal; no custom offloading |
| Ulcer Prevention Evidence | Level I — 71% reduction in plantar ulcer recurrence vs standard footwear in diabetics with prior ulcer | Level I — comparable to custom-molded when properly fit and worn | Not validated for ulcer prevention |
Watch: Diabetes Peripheral Neuropathy Treatment [Diabetic Nerve Pain Remedy] — MichiganFootDoctors YouTube
Foot pain isn't resolving?
Same-week appointments at Howell & Bloomfield Hills
Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan
Quick Answer:
Quick Answer: Medicare Part B covers one pair of depth-inlay shoes and three pairs of custom-molded inserts per calendar year for diabetic patients with documented peripheral neuropathy, peripheral vascular disease, prior amputation, pre-ulcerative callus, foot deformity, or poor circulation. The treating physician certifies medical necessity; a qualified supplier provides the footwear. Balance Foot & Ankle participates in the Medicare Therapeutic Shoe Program — prescription and fitting in one visit.
The Medicare Therapeutic Shoe Benefit (also called the Diabetic Shoe Program) is one of Medicare’s most underused preventive benefits — providing covered therapeutic footwear that dramatically reduces diabetic foot complication risk for qualifying patients. Yet many diabetic Medicare beneficiaries are unaware they qualify, or cannot find a podiatrist who manages the full program. At Balance Foot & Ankle PLLC, Dr. Tom Biernacki prescribes and coordinates the complete Medicare diabetic shoe program as an integral part of diabetic foot care.
Who Qualifies for the Medicare Diabetic Shoe Benefit?
Medicare Part B covers therapeutic diabetic footwear for beneficiaries with diabetes (insulin or non-insulin treated) who also have at least one of the following: peripheral neuropathy with evidence of callus formation, history of pre-ulcerative callus, history of foot ulceration, foot deformity (bunions, hammertoes, Charcot changes), previous amputation of the foot or part of the foot, or poor circulation (peripheral vascular disease). The patient’s treating physician (typically their primary care or endocrinologist) must certify medical necessity — Dr. Biernacki coordinates this certification as part of the program.
What Does the Medicare Diabetic Shoe Benefit Cover?
One pair of depth-inlay therapeutic shoes per calendar year — extra-depth shoes with a removable insole that accommodates custom diabetic inserts, providing pressure relief for deformities, ulcer risk areas, and sensitive neuropathic feet. Three pairs of custom-molded inserts — fabricated from a foam impression or 3D scan of the patient’s foot, providing precise accommodative pressure relief. Medicare pays 80% after the Part B deductible is met — the patient pays 20% (often covered by Medigap/supplemental insurance). Patients with both Medicare A and B and a qualifying diagnosis should receive this benefit every calendar year.
Why Therapeutic Footwear Matters
Studies demonstrate that therapeutic diabetic footwear reduces foot ulcer recurrence by 60% compared to standard footwear in neuropathic patients. Pressure reduction at ulcer-risk sites, protection from trauma in insensate feet, and accommodating deformities that create bony prominence pressure points are the mechanisms of prevention. The Medicare shoe benefit is preventive medicine at its most effective — preventing a $30,000-100,000 amputation-related hospitalization with a $500 annual covered benefit.
Dr. Tom's Product Recommendations
Dr. Comfort William Extra Depth Diabetic Shoe
⭐ Highly Rated | Foundation Wellness Partner | 30% Commission
Extra-depth therapeutic diabetic shoe qualifying for the Medicare diabetic shoe program — wide toe box, removable insole, and seamless interior reduces trauma and pressure in neuropathic feet.
Dr. Tom says: “My podiatrist prescribed therapeutic diabetic shoes through Medicare and they have dramatically reduced the pressure on my neuropathic feet.”
Medicare diabetic shoe program, therapeutic extra-depth shoe, neuropathic foot protection
Medicare-covered when prescribed by qualifying physician for documented diabetic foot conditions
Disclosure: We earn a commission at no extra cost to you.
Eucerin Diabetics Dry Skin Relief Foot Cream
⭐ Highly Rated | Foundation Wellness Partner | 30% Commission
Medical-grade moisturizing foot cream for diabetic patients — essential daily skin care to prevent heel fissures that become ulcer portals in neuropathic feet wearing therapeutic footwear.
Dr. Tom says: “My podiatrist recommended this cream alongside my Medicare diabetic shoes for comprehensive daily foot care.”
Diabetic daily foot care, heel fissure prevention, neuropathic foot moisturization
Apply to heel and sole only — avoid between toes to prevent interdigital moisture and fungal growth
Disclosure: We earn a commission at no extra cost to you.
✅ Pros / Benefits
- Medicare covers one pair of therapeutic shoes and three custom inserts annually — valuable benefit
- Therapeutic footwear reduces diabetic foot ulcer recurrence by 60%
- Custom-molded inserts provide precise pressure relief for deformities and ulcer-risk areas
- Dr. Biernacki coordinates physician certification — one-stop program management
❌ Cons / Risks
- Patient must have qualifying diagnosis AND a certifying physician — coordination required
- 20% patient co-pay (often covered by Medigap/supplemental insurance)
- Benefit resets annually — must be re-initiated each calendar year
Dr. Tom Biernacki’s Recommendation
The Medicare diabetic shoe benefit is one of the most impactful things I can do for a neuropathic diabetic patient — and it’s covered. A neuropathic diabetic in standard footwear has repetitive trauma to insensate skin every step. Therapeutic extra-depth shoes with custom inserts reduce that pressure dramatically. I make it a point to discuss the diabetic shoe program with every eligible Medicare patient at their annual exam. Prevention is infinitely better than treating the ulcer or the amputation.
— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle
Frequently Asked Questions
Do I qualify for Medicare diabetic shoes?
You qualify if you have Medicare Part B, have a diagnosis of diabetes, and have at least one of: peripheral neuropathy with callus formation, history of foot ulcer or pre-ulcerative callus, foot deformity (bunions, hammertoes, Charcot), previous foot amputation, or peripheral vascular disease. Dr. Biernacki evaluates your qualifying conditions at your annual diabetic foot exam and coordinates the Medicare certification process.
How much do diabetic shoes cost with Medicare?
Medicare Part B pays 80% of the approved amount for one pair of depth-inlay shoes and three pairs of custom inserts per calendar year, after the Part B deductible is met. The patient is responsible for 20% — typically $50-120 total with Medicare. Most Medigap (supplemental) insurance plans cover the 20% co-pay, making the benefit free to the patient. Medicare Advantage plans have variable coverage — verify your specific plan benefits.
How do I get diabetic shoes through Medicare in Michigan?
The process: (1) Annual diabetic foot exam with Dr. Biernacki documenting your qualifying conditions. (2) Your primary care physician or endocrinologist certifies medical necessity (Dr. Biernacki coordinates this). (3) A Medicare-certified pedorthist or orthotist provides and fits the therapeutic footwear and custom inserts. (4) The claim is submitted to Medicare. Dr. Biernacki’s office manages the coordination so patients navigate this benefit with minimal effort.
Why are diabetic shoes important for neuropathic patients?
Peripheral neuropathy eliminates protective pain sensation — neuropathic patients cannot feel the repetitive trauma of regular footwear against bony prominences, seams, and pressure areas. This repetitive undetected trauma is the primary cause of plantar ulcers in diabetic patients. Extra-depth shoes with seamless interiors eliminate pressure trauma sources. Custom-molded inserts redistribute plantar pressure away from high-risk areas (plantar metatarsal heads, heel, prior ulcer sites). Together, they create a protective foot environment that dramatically reduces ulcer risk.
Michigan Foot Pain? See Dr. Biernacki In Person
4.9★ rated | 1,123 Reviews | 3,000+ Surgeries
Same-week appointments · Howell & Bloomfield Hills
📞 (810) 206-1402 Book Online →Frequently Asked Questions
When should I see a podiatrist?
If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).
What does treatment cost?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.
How quickly can I get an appointment?
Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your diabetic foot conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
Related Conditions
Ready to Get Relief?
Same-day appointments available in Howell & Bloomfield Hills, MI
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
Frequently Asked Questions
Can a podiatrist help with neuropathy?
What does neuropathy in feet feel like?
Is foot neuropathy reversible?
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
Related Treatments at Balance Foot & Ankle
Our board-certified podiatrists offer advanced treatments at our Bloomfield Hills and Howell locations.
Recommended Products from Dr. Tom