T he following podiatry services are not covered under the medical assistance program:

1. (1) Stock orthopedic shoes, unless covered under chapter 67:16:11 for children less than twenty-one years of age, or built into a leg brace;
2. (2) The treatment of flatfoot;

3. (3) Surgical or nonsurgical treatment of subluxations of the foot, undertaken for the sole purpose of correcting a subluxated structure in the foot as an isolated entity, but not including:

   1. (a) Surgical correction of a subluxated foot structure that is an integral part of the treatment of a foot injury; or
   2. (b) Surgical correction of a subluxated foot structure that is undertaken to improve the function of the foot or to alleviate an inducted or associated symptomatic condition;

4. (4) Routine foot care, unless infected or eczematized, or the individual has been diagnosed with metabolic, neurologic, or peripheral vascular disease:

   1. (a) Cutting or removing corns or calluses;
   2. (b) Trimming nails;
   3. (c) Hygienic and preventive maintenance care;
   4. (d) Using skin creams to maintain the skin tone of ambulatory and bedfast patients; and
   5. (e) The provision of services in the absence of localized illness, injury, or symptoms involving the foot; and

5. (5) Treatment of a fungal infection of the toenail, unless there is clinical evidence of mycosis of the toenail and medical evidence documenting that:

   1. (a) The patient has a marked limitation of ambulation requiring active treatment of the foot; or
   2. (b) The patient is nonambulatory and has a condition that is likely to result in significant medical complication in the absence of treatment.

Source: 1 SDR 30, effective October 13, 1974; repealed, 3 SDR 26, effective October 6, 1976; readopted, 16 SDR 114, effective January 15, 1990; 16 SDR 227, effective June 25, 1990; 33 SDR 125, effective January 31, 2007; 44 SDR 94, effective December 4, 2017; 46 SDR 50, effective October 10, 2019 ; 49 SDR 21, effective September 12, 2022; 50 SDR 63, effective November 27, 2023 .

General Authority: SDCL 28-6-1 .

Law Implemented: SDCL 28-6-1 .

Prior versions effective: 2022-09-12, 2019-10-10, 2017-12-04, 2007-01-31.