1. (a) Services provided by podiatrists, acting within the scope of their practice as authorized by California law, are covered subject to the following:

   1. (1) Podiatric office visits described by procedure codes 99201-99203 and 99211-99213 in the latest edition of the Physicians' Current Procedural Terminology are covered as medically necessary. All other outpatient podiatry services are subject to prior authorization and are limited to medical and surgical services necessary to treat disorders of the feet, ankles, or tendons that insert into the foot, secondary to or complicating chronic medical diseases, or which significantly impair the ability to walk.

      Editorial Note: For full incorporation by reference of the Physicians' Current Procedural Terminology Codes, see CCR, Title 22, section 51050.

   2. (2) Podiatry services rendered on an emergency basis are exempt from prior authorization. Emergency services shall conform to and be in compliance with the provisions of section 51056.
   3. (3) Podiatry services rendered to hospital, skilled nursing facility or intermediate care facility inpatients are covered only when provided pursuant to an order on the patient's chart, signed by the physician or podiatrist who admitted the patient, specifying the care to be given. Services to skilled nursing facility and intermediate care facility inpatients are further subject to prior authorization.
   4. (4) Hospitalization of patients by podiatrists is subject to the procedures set forth in section 51327. Podiatry services provided to hospital inpatients are covered only to the extent that the period of hospitalization is covered by the program.
2. (b) Routine nail trimming is not covered.

Note: Authority cited: Sections 10725, 14105 and 14124.5, Welfare and Institutions Code; and Section 57(c), Chapter 328, Statutes of 1982. Reference: Sections 14131, 14132, 14133, 14133.1 and 14133.25, Welfare and Institutions Code; Section 2472, Business and Professions Code; Section 52, Chapter 328, Statutes of 1982; and Section 433.123, Title 42 of the Code of Federal Regulations.

History

1. Amendment filed 12-28-73 as an emergency; designated effective 1-1-74. Certificate of Compliance included (Register 73, No. 52). For prior history, see Register 72, No. 31.

2. Amendment filed 5-14-76 as an emergency; effective upon filing (Register 76, No. 20).

3. Certificate of Compliance filed 9-8-76 (Register 76, No. 37).

4. Amendment of subsection (a) (1) filed 9-1-82 as an emergency; effective upon filing (Register 82, No. 37). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-30-82.

5. Certificate of Compliance as to 9-1-83 order transmitted to OAL 12-30-82 (the portion pertaining to subsection (a) (1) was withdrawn 1-28-83) and filed 2-7-83 (Register 83, No. 10).

6. Amendment of subsection (a) (1) refiled 1-28-83 as an emergency; effective upon filing (Register 83, No. 10). (Corrected copy of 1-28-83 emergency order refiled 2-16-83.) A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 5-28-83.

7. Emergency language repealed by operation of Government Code section 11346.1(f) (Register 83, No. 27).

8. Amendment of subsection (a)(1) filed 6-29-83 as an emergency; effective upon filing (Register 83, No. 27). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 10-27-83.

9. Certificate of Compliance, including editorial correction of subsection (a)(1), as to 6-29-83 order filed 8-11-83 (Register 83, No. 33).

10. Editorial correction of Editorial Note of subsection (a)(1) filed 4-11-84 (Register 84, No. 15).

11. Change without regulatory effect of Note (Register 86, No. 49).

12. Amendment of subsection (a)(1) filed 10-1-87; operative 10-31-87 (Register 87, No. 41).

13. Amendment of subsection (a)(1) filed 4-9-90; operative 4-9-90 (Register 90, No. 17).

14. Amendment of subsection (a)(1) and Note filed 3-9-93; operative 3-9-93 (Register 93, No. 11).