Certifications & Insurance Coverage

BILLY Footwear's adaptive designs are recognized in both Canada and the United States. Here's what that means, and how it may relate to insurance coverage.

Canada — CPMA

Select BILLY lines — including the Comfort, D|R, and Goat series — are certified by the Canadian Podiatric Medical Association (CPMA), which recognizes footwear that supports foot health.

United States — PDAC / HCPCS Coding

Select BILLY Footwear models are PDAC-approved and HCPCS-coded in the U.S. for therapeutic diabetic and orthopedic footwear categories, including A5500 and select L-series orthopedic shoe codes. Coverage and reimbursement depend on patient eligibility, diagnosis, prescription, and insurer/Medicare documentation requirements.

What PDAC approval means

PDAC (Pricing, Data Analysis and Coding) is the process used by the U.S. Centers for Medicare & Medicaid Services (CMS) to verify a product against a specific HCPCS Level II code for Medicare billing. A PDAC-approved product has been reviewed, assigned a code, and published in the Durable Medical Equipment Coding System (DMECS). A5500 covers off-the-shelf therapeutic shoes for persons with diabetes; the L-series codes cover orthopedic footwear categories.

Important: An HCPCS code assignment is not an endorsement by PDAC, the DME MACs, or Medicare, and does not guarantee reimbursement. Coverage depends on the patient's diagnosis, a physician's prescription, and the documentation requirements of Medicare or the patient's insurer.

PDAC / HCPCS codes by model

To find out whether a specific BILLY style may be covered for you or your patient, consult the prescribing physician and your insurer or Medicare administrator with the applicable code(s) above.

This page is provided for informational purposes only and does not constitute medical or reimbursement advice.