Podiatry practice marketing: Medicare foot care rules and honest claims

Podiatry marketing has a particular risk that most specialties do not: a large share of patients are on Medicare, and Medicare draws a firm line between covered foot care and routine foot care. Ads and web pages that blur that line can set expectations the practice cannot meet, and offers aimed at Medicare patients raise their own federal questions.

This guide covers those rules, plus the claim and local search issues that come up for foot and ankle practices. It does not cover coding or billing, which belong with your billing team. For laser treatment of toenail fungus, see laser nail fungus treatment marketing.

What Medicare says about routine foot care

Under 42 CFR 411.15(l)(1), Medicare excludes, with exceptions, services in connection with:

• Routine foot care, such as cutting or removal of corns or calluses, trimming of nails, routine hygienic care, and any service performed in the absence of localized illness, injury, or symptoms involving the feet.
• The evaluation or treatment of subluxations of the feet.
• The evaluation or treatment of flattened arches, including the prescription of supportive devices.

The regulation lists exceptions in 411.15(l)(2): treatment of warts is not excluded; treatment of mycotic toenails may be covered within stated limits; and the listed services are not excluded when they are part of a primary covered procedure on the foot, or when they are initial diagnostic services for a specific symptom or complaint that might arise from a condition whose treatment would be covered.

Medicare.gov explains the same rule in plain language: Medicare does not usually cover routine foot care, such as cutting or removing corns and calluses, trimming nails, or hygienic or other preventive maintenance, and patients usually pay all costs for non-covered services like routine foot care.

Diabetic foot care and therapeutic shoes

Medicare.gov describes two separate benefits that often come up in podiatry marketing. Part B covers some diabetes-related foot care every 6 months for eligible patients: foot exams or treatment for people with diabetes-related lower leg nerve damage that can increase the risk of limb loss, and the eligibility rule is diabetic peripheral neuropathy with loss of protective sensation. Part B also covers therapeutic shoes and inserts for people with diabetes and severe diabetes-related foot disease who meet the eligibility conditions, and only when the doctors and suppliers involved are enrolled in Medicare.

For marketing, the practical rules are:

• Do not advertise nail trimming, callus care or general foot maintenance as “covered by Medicare”. The regulation and Medicare.gov describe these as usually not covered.
• If you promote diabetic foot exams or therapeutic shoes, describe who is eligible in Medicare’s own terms and say that coverage depends on the patient’s situation.
• Avoid “free shoes for diabetics” or “at no cost to you” wording. Medicare.gov states patients pay 20% of the Medicare-approved amount after the Part B deductible for these benefits, and plans differ.
• Ask patients to check their own coverage, and name the Medicare Advantage or commercial plans you accept rather than promising coverage.

Offers aimed at Medicare patients

Free screenings, gift cards and waived costs are common in other specialties. With Medicare patients they carry a specific federal risk. 42 U.S.C. 1320a-7a(a)(5) allows civil monetary penalties against a person who offers or transfers remuneration to a Medicare or state health care program beneficiary that the person knows or should know is likely to influence the beneficiary to order or receive items or services from a particular provider, practitioner or supplier, where payment may be made by Medicare or a state program.

The statute has definitions and exceptions, so this is a question for a health care attorney before any promotion that offers something of value to patients who may be on Medicare or Medicaid. An educational talk on foot health for people with diabetes is a different thing from a free item tied to booking.

Claims about treatments and devices

The FTC Health Products Compliance Guidance applies to health-related products and services and says claims about health benefits need competent and reliable scientific evidence. Common podiatry claims to check:

1. Device status. FDA explains that under premarket notification, known as 510(k), a manufacturer must show FDA that its device is substantially equivalent to a device already on the market, while products with new materials or design that differ from those on the market need a premarket approval application. If a laser or other device was cleared, describe it as FDA cleared for its cleared use, not as FDA approved.
2. Results. Avoid “cure”, “permanent” or “pain-free in one visit” unless you can substantiate them. Results vary, and claims made by a device manufacturer become your claims when you repeat them.
3. Surgery. Describe procedures, recovery and who performs them accurately. Do not imply a procedure is risk-free.
4. Testimonials. Patient stories are read as typical results under 16 CFR 255.2(b). See our guide to patient testimonials for the FTC and HIPAA rules.

Local search for a foot and ankle practice

Most podiatry patients search locally and by problem: heel pain, an ingrown toenail, a sports injury, a diabetic foot check. Pages that describe each condition you treat, who treats it and how to book will usually answer those searches better than a single services list. Keep your Google Business Profile name, categories, hours and services accurate. Our guide to Google Business Profile for doctors covers the rules, and many podiatry patients are older adults, so website accessibility matters too: readable text sizes, good contrast and forms that work with a keyboard.

If you see patients for wound care or in nursing facilities, keep those pages factual and free of patient details. Referral relationships with primary care physicians are covered in patient and physician referrals.

A podiatry practice that runs a neuropathy program faces its own claims about reversing nerve damage, cleared devices and dinner seminars. Our guide to neuropathy clinic marketing covers them.

How we help

We build podiatry websites and local search around the conditions you treat, with coverage language that matches Medicare’s own wording and no outcome promises. We do not give legal or billing advice. See our healthcare SEO and medical website design services, or the full list in our healthcare marketing rules guide.

Frequently asked questions

Sources

• 42 CFR 411.15: Particular services excluded from coverage (paragraph (l), foot care)
• Medicare.gov: Foot care
• Medicare.gov: Foot care (for diabetes)
• Medicare.gov: Therapeutic shoes and inserts
• 42 U.S.C. 1320a-7a: Civil monetary penalties
• FTC: Health Products Compliance Guidance (December 2022)
• FDA: Learn if a medical device has been cleared by FDA for marketing
• 16 CFR 255.2: Consumer endorsements

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