Pedorthics, orthoses, and therapeutic footwear, made simple.
This page distills guidance from the Pedorthic Footcare Association (Pedorthics.org) into plain English, so you know what a credentialed pedorthist does, when footwear helps, and how benefits like Medicare’s therapeutic shoe program work.
What is pedorthics?
Pedorthics is the specialty focused on using footwear, shoes, shoe modifications, and foot orthoses, to help manage conditions of the foot and lower limb, improving comfort and function for everyday life and work.
In practice, that means fitting the right shoe, adding the right insert or modification, and educating you on wear, care, and when to follow up.
What does a credentialed pedorthist do?
Scope at a glance
- Evaluates footwear needs related to comfort, pressure relief, and stability.
- Selects and fits therapeutic shoes and inserts; designs modifications when needed.
- Educates patients on use, break-in, and follow-up care.
Credentialing
Pedorthists complete formal education and pass certification (e.g., ABC/BOC). Ongoing education keeps skills current with best practices and coding guidance.
Team approach
They often work with physicians, podiatrists, orthotists, and PTs, especially for diabetes, arthritis, and post-surgical recovery.
Orthoses (orthotics): what they do
A foot orthosis is an insert that supports or redistributes pressure to protect tissue and improve function. It works inside the shoe and does not extend above the ankle. Materials and rigidity vary by goal, cushioning, off-loading, control, or a blend.
- Prefabricated options for simple cushioning/arch support.
- Custom orthoses for targeted off-loading or persistent issues.
Great outcomes = the right insert plus the right shoe volume and shape.
Common footwear modifications
When an insert alone isn’t enough, shoes can be safely altered to fine-tune pressure, balance, and toe-off. Examples your provider may recommend:
Rocker bottoms
Helps roll through stance and reduce forefoot pressure during push-off.
Heel/sole wedges
Subtle posting to influence alignment and relieve localized stress.
Metatarsal bars
Shifts load away from tender met heads to improve comfort.
Flares & buttresses
Broaden the base or add support to improve stability.
Stretching & spot-relief
Accommodates bunions, hammertoes, or sensitive prominences.
Depth & volume changes
Roomier interiors for orthoses and swelling without tight spots.
Your pedorthist will choose the least-invasive option that achieves the goal, and ensure footwear remains protective and durable.
Medicare’s therapeutic shoes for people with diabetes (TSB)
Medicare Part B may cover extra-depth or custom shoes and inserts each calendar year for eligible patients with diabetes, when the prescribing doctor documents medical need and a qualified supplier fits and furnishes them.
- Includes shoes and a set number of inserts and/or specific shoe modifications per year.
- Documentation must name separate modifications if they’re billed (e.g., rocker sole, wedge, met bar).
- Items must be approved products and provided by qualified professionals.
Coverage details and documentation rules change over time, bring your physician’s paperwork to your fitting so we can verify specifics.
Ten tips for a great shoe fit
- Measure both feet; fit the larger.
- Shop later in the day when feet may be fuller.
- Match shoe shape to your foot shape, especially at the toe box.
- Wear the socks you’ll use most with the shoes.
- Check length, width, and depth (space over the toes & orthoses).
- Walk on a firm surface; look for slipping, rubbing, or heel lift.
- Break in gradually; check skin for hot spots early on.
- Replace worn insoles/laces; keep leather conditioned.
- For inserts, ensure the shoe has removable footbeds and adequate volume.
- When in doubt, get measured and fitted professionally.
Find a credentialed pedorthist
Need a specialist outside our area? Use the Pedorthic Footcare Association’s member search to locate a credentialed pedorthist by state or ZIP.
FAQ
Are sandals considered therapeutic footwear?
Sandals can support but generally don’t protect the foot as well as closed-toe shoes or boots. For medical off-loading, closed footwear is often preferred.
Do I need custom orthoses?
Not always. Many goals can be met with prefabricated inserts plus proper shoe selection. If your needs are specific or persistent, custom devices may help.
Who can fit diabetic shoes under Medicare?
Qualified providers (including credentialed pedorthists) can fit and furnish items when the prescribing physician documents medical necessity and all rules are met.
Where can I learn the terminology?
See the Pedorthic Footcare Association’s glossary for common terms related to shoes, inserts, and modifications.
Vincennes, Indiana
906 N 7th St, Vincennes, IN 47591
Phone: (812) 882-4770 • Email: info@grundmanshoe.com