Helping Your Provider Prescribe You the Right Orthopedic Footwear

Here’s how to talk to your provider — and what they’ll need to do.

Step 1: Confirm You Might Be Eligible

Medicare only covers orthopedic footwear when it's medically necessary. That means the shoes must be prescribed to help with one of the following:

• You’ve had a partial foot amputation and need a prosthetic shoe (HCPCS code L3250).

• You need the shoes to support a brace or orthosis.

• You have a condition that makes walking difficult, and your provider documents a medical need for the shoes.

Tip: Your provider must include a diagnosis code that supports this need. Medicare will deny claims if the diagnosis doesn’t match their approved list.

Step 2: Ask for a Standard Written Order (SWO)

Before your shoes can be delivered or billed to Medicare, your provider must write a Standard Written Order (SWO) and send it to the supplier. The order must include:

• Your name

• A detailed description of the footwear (including HCPCS code)

• Quantity needed

• Date of the order

• Your provider’s signature and date

Without this order, Medicare will deny the claim.

Step 3: Make Sure Your Provider Documents Medical Necessity

In addition to writing the order, your provider must document in your medical record:

• Why you need orthopedic shoes

• What condition or diagnosis supports this

• Any continued need or use if it’s a replacement

• How the shoes will improve your mobility or functioning

If this information isn’t in your record, your claim can still be denied, even with a valid order.

Step 4: Work with a Medicare-Approved Supplier

The supplier must:

• Get the completed SWO before delivering the shoes

• Ensure all proof of delivery is documented

• Correctly code the item using HCPCS codes

• Keep records in case Medicare requests them later

What Codes Might Be Used?

Your provider or supplier may use any of these common HCPCS codes:

• L3250 – Custom molded, prosthetic shoe (used after partial foot amputation)

• L3215-L3225 – Orthopedic footwear, standard or used with a brace

• L3000-L3060 – Various inserts, arch supports, or molded orthotics

Tip: Ask your provider which code they are using — and make sure it’s listed on the order.

Recap: What to Ask Your Provider

Here’s a simple script you can use:

“I’m having trouble walking and think I may benefit from orthopedic footwear. I understand Medicare may cover it if it’s medically necessary. Could you help me with a Standard Written Order and make sure my diagnosis and the medical need are documented in my records?”