<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s22191a4b-7fc9-41d6-be50-61f1147f2f20P0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s22191a4b-7fc9-41d6-be50-61f1147f2f20C0 { color: #000000; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000001 { color: #000000; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s22191a4b-7fc9-41d6-be50-61f1147f2f20000002 { color: #000000; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:07:04"><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000000">67:16:07:04</span></a><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000001">.  Services not covered.</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">T</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">he following podiatry services are not covered under the medical assistance program:</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    (1)  Stock orthopedic shoes</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">,</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> unless covered under chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:11"><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000003">67:16:11</span></a><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> for children </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">less than</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">twenty-one years of age,</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> or</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">built into a leg brace;</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    (2)  </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">The t</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">reatment of flatfoot;</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    (3)  Surgical or nonsurgical treatment of subluxations of the foot</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">,</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> undertaken for the sole purpose of correcting a subluxated structure in the foot as an isolated entity</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">, but not including:</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (a)  S</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">urgical correction of a subluxated foot structure that is an integral part of the treatment of a foot injury</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">;</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> or</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (b)  Surgical correction of a subluxated foot structure</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> that is undertaken to improve the function of the foot or to alleviate an inducted or associated symptomatic condition;</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    (4)  Routine foot care</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">,</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> unless infected or eczematized, or the individual has been diagnosed with metabolic, neurologic, or peripheral vascular dis</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">ease:</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (a)  C</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">utting or removing corns or calluses</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">;</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (b)  T</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">rimming nails</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">;</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (c)  Hygienic</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> and preventive maintenance care</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">;</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (d)  U</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">sing skin creams to maintain </span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">the </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">skin tone of ambulatory and bedfast patients; and</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (e)  The provision of </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">services in the absence of localized illness, injury, or symptoms involving the foot;</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> and</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    (5)  Treatment of a fungal infection of the toenail</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">,</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> unless there is clinical evidence of mycosis of the toenail and medical evidence documenting that</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">:</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (a)  T</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">he patient has a marked limitation of ambulation requiring active treatment of the foot</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">; </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">or</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">            (b)  The patient</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> i</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">s</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> nonambulatory</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> and </span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> has a condition that is likely to result in significant medical complication in the absence of treatment.</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000001">Source:</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> 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</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">; 49 SDR 21, effective September 12, 2022; 50 SDR 63, effective November 27, 2023</span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">.</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000001">General Authority:</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000003">28-6-1</span></a><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">.</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">    </span><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000001">Law Implemented:</span><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0-000003">28-6-1</span></a><span class="s22191a4b-7fc9-41d6-be50-61f1147f2f20C0">.</span></p><p dir="ltr" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20P0"><span xml:space="preserve" class="s22191a4b-7fc9-41d6-be50-61f1147f2f20000002"> </span></p></div></body></html>