If you have a medical problem with your ankles or feet, you may need to see a medical professional called a podiatrist.
In the state of Pennsylvania, treatment by a podiatrist may be covered by Medicaid. Below we’ll discuss what a podiatrist can do for you and how you may be able to get Medicaid coverage for the treatment. We have also listed some of the best podiatrists in Pennsylvania, including those who accept Medicaid.
What is a podiatrist?
A podiatrist, or doctor of podiatric medicine (DPM), is a physician (and often a surgeon as well) who treats problems with a patient’s lower leg. This includes the feet, ankles, toes, and often the related muscles, bones, joints, and soft tissues around them.
Podiatrists do not complete traditional medical school and cannot act as a medical doctor (MD). Like other doctors, they get four years of schooling, but they attend a program specifically for podiatric medicine. In addition, podiatrists also complete a 3-year hospital residency training program. Some go on to complete fellowship training as well if they are going to specialize in a specific area of treatment.
The best podiatrists often continue with advanced training and clinical experience throughout their careers and develop a subspeciality in surgery, orthopedics, dermatology, sports medicine, pediatrics, geriatrics, radiology, diabetic foot care, and even public health. But in general, a podiatrist should be able to give you advice and treatment in most of these areas.
Podiatrists can become certified by the American Board of Foot and Ankle Surgery and/or the American Board of Podiatric Medicine, but this is voluntary. Podiatrists do not have to be “board-certified.”
The only mandatory requirement for becoming a podiatrist is registration with the Health and Care Professions Council (HCPC). But registration requires the successful completion of an approved Bachelors or Master’s degree program in podiatry.
What do podiatrists do?
Podiatrists diagnose and treat conditions of the lower limbs and feet. More specifically, a podiatrist is trained to tell you why your ankle or foot looks or feels abnormal and help you address the underlying cause.
A podiatrist can do the following:
– Diagnose and treat issues related to the feet, ankles, and toes
– Set fractures and treat broken bones in the feet, ankles, and toes
– Write appropriate prescriptions for your condition, including to help manage pain
– Order lab tests and X-rays to diagnose a condition or plan surgery
– Treat plantar fasciitis, foot ulcers, and calluses
– Advise patients about proper foot hygiene
– Diagnose some dermatological (skin) conditions of the foot
– Recommend a physical therapist or orthopedist if treatment is beyond the scope of their training
– Perform some surgeries, depending on their training
Most podiatrists can perform the following types of surgeries:
– Ingrown toenail surgery
– Bunion surgery and corn removal
– Metatarsal foot surgery to treat arthritis
– Hammertoe surgery
– Achilles tendon surgery
However, not all podiatrists can perform all surgeries. Furthermore, if you have an issue with your larger musculoskeletal system or require more advanced surgery, you may be referred to an orthopedic surgeon.
Because podiatrists treat the feet and lower leg areas, they may also play a key role in helping patients manage conditions related to blood circulation, such as high blood pressure and diabetes, which can affect the lower limbs and feet.
What is Medicaid?
Medicaid provides free or low-cost health insurance coverage to very low income Americans, as well as children, pregnant women, elderly adults, and people with disabilities. While it is a federal program, it is administered by individual states. Therefore, Medicaid coverage can look different depending on where you live.
In the state of Pennsylvania, the Medicaid program is called “Medical Assistance,” or MA. Pennsylvanians must apply for Medicaid coverage through the state’s COMPASS portal and renew their benefits each year. The County Assistance Office (CAO) is in charge of administering the program and approving benefits.
Do podiatrists in Pennsylvania take Medicaid?
Federal law requires that states cover certain medical benefits such as inpatient hospital services as well as lab and X-ray services. But foot care isn’t considered a mandatory Medicaid benefit.
However, Pennsylvania has elected to provide payment for some medically necessary podiatric services.
To use Medicaid/Medical Assistance to pay for a visit to a podiatrist in Pennsylvania, a patient must:
– Be deemed “medically needy” by a doctor
– Receive prior authorization from the state MA office
– See a podiatrist who is an enrolled provider in the MA program
– Receive treatment for an approved condition
– Not be eligible for full payment through another public agency or insurance program
You will be informed by your doctor or podiatrist of the services that are covered or not covered by the Pennsylvania MA program before treatment. But, in general, MA will cover the following for eligible recipients:
– Medically necessary office visits and consultations to diagnose foot, ankle, and toe problems
– Medically justified lab tests and X-rays requested by the podiatrist who examines you
– Orthopedic shoes and inserts for those under 20 years of age
– Medically justified treatments and prescriptions that are viewed as standard practice by the medical community (this means no experimental treatments or off-label prescription use will be covered)
Medicaid coverage can be confusing, but you have the right to an explanation of your benefits (including translation services) to ensure that you understand treatment and payment options in advance of receiving care. You also have the right to appeal decisions made by the Pennsylvania MA office if you feel they were mistaken in denying you coverage for a medically necessary service.
Top 10 podiatrists in Pennsylvania
1. Kenneth J. D’Ortone
2429 Brown St
Philadelphia, PA 19130
2. Donald S. Malay
3801 Market St
Philadelphia, PA 19104
3. David G. Geltzer
6641 Germantown Ave
Philadelphia, PA 19119
4. Michael F. Zarro
1546 Packer Ave
Philadelphia, PA 19145
5. Andrew Peacock
1740 South St #500
Philadelphia, PA 19146
The following podiatrists in Pennsylvania accept Medicaid:
6. John H. Geovjian
600 Magnolia Ave
Glenolden, PA 19036
7. Harry C. Snyder
4064 William Penn Hwy #2
Murrysville, PA 15668
8. Kent V. Flinchbaugh
2600 Willow Street Pike
Willow Street, PA 17584
9. Robert J. Kaplan
1901 Hay Terrace
Easton, PA 18042
10. Kirk W. Davis
601 Wayne Ave
Chambersburg, PA 17201