CMS Sample Beneficiary Letter Dear Mrs$.$ Jones Your son has written the Centers for Medicare & Medicaid Services on your behalf, asking if Medicare would reimburse you if you purchased lifts for your shoes. However, for any item to be covered by Medicare, it must: be eligible for a defined Medicare benefit category; be reasonable and necessary for the diagnosis or treatment of illness or injury to improve the functioning of a malformed body memberand meet all other applicable Medicare statutory and regulatory requirements Therefore, for Medicare to cover lifts in your shoes, your doctor must sign and an order $($ if applicable$)$ stating that you need lifts in your shoes because of your medical condition. The order Certificate of Medical Necessity"$($and prescription$)$ must be a supplier before a claim is submitted to the durable medical equipment regional camer the supplier bills for an item, such as lifts for shoes, without first receiving the completed order, the item or lifts for shoes will be denied as not medically necessary. Shoes, inserts and modifications are covered in limited circumstances They are covered in selected patients with diabetes for the prevention or treatment of diabetic foot ulcers. Additionally, inserts and other shoe modifications are covered they are on a shoe that is an integral part of a covered brace and if they are medically necessary

for the proper functioning of the brace.

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