D. Podiatrists

A podiatrist is included within the definition of “physician” but only with respect to those functions which the podiatrist is legally authorized to perform in the State in which the individualperforms them. This means that the professional services provided by a podiatrist within the scope of applicable State license (except those services which are specifically excluded) are “physician's services” reimbursable on a reasonable charge basis under Part B.

Podiatrists may hold any of the following professional degrees of which the first three are the most common: Pod.D or D.P. (Doctor of Podiatry), D.S.C. (Doctor of Surgical Chiropody), D.P.M. (Doctor of Podiatric Medicine), D.S.P. (Doctor of Surgical Podiatry), Graduate in Podiatry, Master Chiropodist, Graduate Chiropodist, or in a very few instances another podiatry degree. Within a particular State, all individuals holding any of these degrees are licensed to perform the same functions; however, there are variations from State to State as to the authorized scope of podiatric practice.

A podiatrist is considered a “physician” for any of the following purposes:

1. for making the required physician certification and recertifications of the medical necessity for Part A and Part B provider services;

2. for the purpose of establishing and periodically reviewing a home health plan of treatment; and for purposes of constituting a member of a Utilization Review (UR) committee but only if: a. the performance of these functions is consistent with the policy of the institution or agency with respect to which the podiatrist performs them; b. the podiatrist is legally authorized by the State to perform such functions; and c. at least two of the physicians on the UR committee are doctors of medicine or osteopathy.