Routine Foot Care

Date: 02/12/25

Ambetter Health reimburses for routine foot care in accordance with state mandates and CMS guidelines. Routine Foot Care services are not restricted to podiatrists. These services may be used by any certified physician or non-physician (NPP) specialty. Based on CMS guide for routine foot care modifiers Q7, Q8 and Q9 are being added to further ensure Ambetter Health benefit(s) are applying routine foot care cost share for routine foot care services.

All other services will apply Surgical/Specialist/Doctor/Facility cost share depending on provider billing. 

Effective 1/1/2025 routine foot care benefit(s) will be updated to align with the CMS guidance provided in Article - Billing and Coding: Routine Foot Care (A57957) (cms.gov).External Link

Prior authorization may be required. Please reference the Provider Resource page.