Medical Foot Care: What Qualifies as an At-Risk Foot Exam

Why routine foot care isn’t part of the visit – and what qualifies as medically necessary.

Why You’re Here

Many patients think they’re coming in to “just get my toenails cut.” But the truth is, nail and skin care is only performed when medically necessary. This approach isn’t about billing—it’s about safety, clinical standards, and long-term foot health.

What Counts as At-Risk Foot Care?

Routine nail trimming or callus shaving is not considered treatment unless there is a documented medical risk.

Patients may qualify for medically necessary care if they have:

Diabetes with nerve damage or poor circulation
Thick or painful nails caused by a medical condition
A history of foot ulcers or amputations

Does the Foot Condition Require Medical Treatment?

Patient Scenario	At-Risk Foot Exam Needed?	Nail Cutting Performed?	Callus Treatment Provided?
Healthy feet, no medical conditions	❌ No	❌ No	❌ No
Thick fungal toenails, no pain or risk	❌ No	❌ No	❌ No
Painful or severely thick fungal toenails	✅ Yes – if impairing function or causing risk	✅ Yes – if medically necessary	❌ No
Diabetes, no nerve/circulation issues	❌ No	❌ No	❌ No
Diabetes with nerve damage	✅ Yes – every 6 months	⚠️ Sometimes – depends on risk	⚠️ Sometimes – if painful or thick
Diabetes & poor circulation or deformity	✅ Yes – every 6 months	✅ Yes – if risk is documented	✅ Yes – if risk is documented
History of ulcer or amputation	✅ Yes – every 3 months	✅ Yes	✅ Yes
Circulatory conditions (non-diabetic)	✅ Possibly – based on risk	⚠️ Possibly	⚠️ Possibly

⚠️ May be provided based on clinical judgment and medical necessity.

What’s Included in an At-Risk Foot Exam?

A full risk assessment includes:

Skin and circulation check
Nerve testing
Pressure point screening
Assessment of deformities, wounds, or infection
Footwear and prevention guidance

If nail or callus treatment is deemed medically necessary, it may be performed during the visit.

Why This Matters

Medical foot care must follow established clinical guidelines. Routine nail care is not provided – even if a patient is willing to pay out of pocket – unless it is part of a necessary medical care plan.

These protocols ensure the right care is delivered at the right time, reducing the risk of complications and aligning with national medical standards.

Questions?

The clinical team is available to answer questions and explain what qualifies as appropriate and safe care.