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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say the Prescribing Practitioner is the person who actually writes the order for the therapeutic shoe, 
modifications and inserts. This practitioner must be knowledgeable in the fitting of diabetic shoes and inserts. 
The prescribing practitioner may be a podiatrist, M.D., D.O., physician assistant, nurse practitioner, or clinical 
nurse specialist. The prescribing practitioner may be the supplier (i.e., the one who furnishes the footwear). 
 
The Supplier is the person or entity that actually furnishes the shoe, modification, and/or insert to the 
beneficiary and that bills Medicare. The supplier may be a podiatrist, pedorthist, orthotist, prosthetist or other 
qualified individual. The Prescribing Practitioner may be the supplier. The Certifying Physician may only be 
the supplier if the certifying physician is practicing in a defined rural area or a defined health professional 
shortage area. 
 
Therapeutic shoes, inserts and/or modifications to therapeutic shoes are covered if all of the following criteria 
are met: 
1.  The beneficiary has diabetes mellitus (Reference diagnosis  code section below); and 
2.  The certifying physician has documented in the beneficiary's medical record one or more of the following  
     conditions:  
     a. Previous amputation of the other foot, or part of either foot, or 
     b. History of previous foot ulceration of either foot, or 
     c. History of pre-ulcerative calluses of either foot, or 
     d. Peripheral neuropathy with evidence of callus formation of either foot, or\ 
     e. Foot deformity of either foot, or 
     f. Poor circulation in either foot; and 
 
 
 
 
 
 
 3.   The certifying physician has certified that indications (1) and (2) are met and that he/she is treating the  
       beneficiary under a comprehensive plan of care for his/her diabetes and that the beneficiary needs diabetic  
       shoes. For claims with dates of service on or after 01/01/2011, the certifying  physician must: 
         - Have an in-person visit with the beneficiary during which diabetes management is addressed within 6  
           months prior to delivery of the shoes/inserts; and - Sign the certification statement (refer to the Policy    
           Specific Documentation Requirements section below) on or after the date of the in-person visit and  
           within  3 months prior to delivery of the shoes/inserts. 
4. Prior to selecting the specific items that will be provided, the supplier must conduct and  
    document an in-person evaluation of the beneficiary. (Refer to the Policy Specific Documentation  
    Requirements section below.) 
5. At the time of in-person delivery to the beneficiary of the items selected, the supplier must  conduct an     
    objective assessment of the fit of the shoe and inserts and document the results. A beneficiary's subjective     
    statements regarding fit as the sole documentation of the in-person  delivery does not meet this criterion. 
 
If criteria 1-5 are not met, the therapeutic shoes, inserts and/or modifications will be denied as noncovered. 
When codes are billed without a KX modifier (see Policy Specific Documentation Requirements section 
below), they will be denied as noncovered. 

You can find this information in the Local Coverage Article Therapeutic Shoes for Persons with Diabetes - Policy Article (A52501). 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.