Medicare & Medicaid Podiatry Coverage for Nursing Home Residents

Reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · 3,000+ surgeries · @MichiganFootDoctors (950K+ subscribers)

Last reviewed May 11, 2026 · (810) 206-1402

Quick answer: Most nursing home residents have significant podiatry coverage. Medicare Part B covers medically necessary foot care in long-term care settings, and Medicaid adds coverage for qualifying residents — but the rules differ by service and by setting. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Medicare & Medicaid Podiatry Coverage for Nursing Home Residents

Understanding Podiatry Coverage in Long-Term Care

Navigating Medicare and Medicaid coverage for podiatric services in nursing home settings is complex — but most residents have significantly more coverage than their families or care coordinators realize. At Balance Foot & Ankle, we handle all billing directly and maximize legitimate covered benefits for every resident we see.

Medicare Coverage for Nursing Home Residents

Medicare Part B covers podiatric services for qualifying nursing home residents. Routine nail care is covered for residents with qualifying systemic conditions (diabetes, peripheral arterial disease, peripheral neuropathy). Diabetic foot exams are a covered annual benefit for all Medicare diabetic patients. Diabetic shoe fitting and dispensing is covered once per calendar year for qualifying diabetics. Treatment of specific foot conditions (ingrown toenails, infections, wounds, corns, and calluses with documented medical necessity) is covered regardless of systemic conditions. New wounds and infections are covered as medical necessities.

Medicaid Coverage

Michigan Medicaid covers podiatric services for nursing home residents, including routine foot care for qualifying conditions. Many residents who are dual-eligible (both Medicare and Medicaid) have virtually no out-of-pocket costs for podiatric care — Medicare pays 80% and Medicaid pays the remaining 20%.

How We Handle Billing

We verify coverage for every resident before the first visit, handle all billing directly with Medicare and Medicaid, provide families and facilities with clear documentation of covered services, and never bill residents for covered services we don’t provide.

Call (810) 206-1402 to discuss podiatric billing for your facility or your loved one’s care.

Medicare and Medicaid Billing for Nursing Home Podiatry in Michigan: What Facilities Need to Know

Michigan nursing homes and skilled nursing facilities that partner with Balance Foot & Ankle benefit from our expertise in Medicare Part B and Medicaid billing for on-site podiatric services. Medicare Part B covers podiatry services in nursing home settings when medically necessary — routine nail care is covered when a systemic condition (diabetes, peripheral arterial disease, peripheral neuropathy) creates documented medical necessity; medically necessary treatment of foot conditions (wound care, debridement, infections, fractures) is covered regardless of systemic condition status. Facilities that rely on contracted podiatrists with billing expertise avoid the compliance risk of inappropriate claims while ensuring residents receive the full range of covered services they are entitled to.

The Medicaid billing framework for Michigan nursing home podiatry differs from Medicare in several respects: Medicaid managed care organizations (MCOs) each have their own authorization requirements and covered service lists, and facilities benefit from a podiatry partner who understands each plan’s specific documentation requirements. Balance Foot & Ankle serves nursing homes in Livingston County (Howell area) and Oakland County (Bloomfield Township area) with on-site podiatry services, handling all insurance verification, prior authorization, and billing documentation. Our facility coordinators work directly with the nursing home’s billing department to ensure clean claims and minimize denials. Nursing home administrators interested in establishing or replacing an on-site podiatry program can contact our facility services coordinator at (810) 206-1402 to discuss visit frequency, documentation processes, and service agreements.

Michigan nursing home administrators evaluating podiatry service options should ask prospective providers three key questions: (1) What is the provider’s process for urgent wound or infection concerns between scheduled visits? (2) How does the provider handle residents who refuse treatment or become agitated during examination? (3) What is the documentation turnaround time for CARE assessments and physician orders requiring podiatry input? At Balance Foot & Ankle, our facility service coordinator answers these questions directly and can provide references from current facility partners in Livingston and Oakland counties. Schedule a no-obligation facility assessment call at (810) 206-1402.

Related Treatment Guides

• Peripheral Arterial Disease Foot Care
• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

Documentation is the foundation of compliant nursing home podiatry billing. At Balance Foot & Ankle, every nursing home encounter includes a signed physician order, a legible SOAP note with relevant diagnosis codes, and a care plan update when the findings affect the resident’s foot health status. Facilities receive a copy of all documentation within 24–48 hours of the visit, and our billing team handles Medicare Part B and Medicaid claims directly — the facility has no billing responsibility for the podiatry services we provide. Call (810) 206-1402 to connect with our facility services coordinator.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

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When to See a Podiatrist

If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Township clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.

Call Balance Foot & Ankle: (810) 206-1402  ·  Book online  ·  Offices in Howell & Bloomfield Township

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Township. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

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