CommercialCoverageMedium impact
Foot Orthotics 1.01.41
Excellus BlueCross BlueShield·Podiatry, Orthopedics, Family Medicine +1 more·Feet (Podiatry)
Effective date
Jun 26, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their foot orthotics policy (1.01.41) effective June 26, 2025, establishing strict criteria for coverage including failed conservative treatment and specific qualifying conditions. The policy explicitly excludes coverage for flat feet, pronation, fallen arches, and over-the-counter orthotics, with most contracts excluding foot orthotic coverage entirely except in limited post-surgical situations.
Action Required
Before June 26, 2025: Billing team must update prior authorization requirements for foot orthotics to verify patient has failed conservative treatment and meets specific qualifying conditions listed in policy. Providers must document symptoms and conservative treatment failure before prescribing orthotics. Stop billing for flat feet, pronation, fallen arches, and OTC orthotics as these are explicitly non-covered. Update encounter forms to include required documentation checklist.