Podiatry Accounting

Medicare pays 40% of your bills. Do you know what that actually costs you?

Podiatry runs on tight margins with heavy Medicare exposure. We track the numbers that keep those margins alive: wound care economics, DME profitability, and per-visit costs.

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At a glance

Investment$3,000–$4,000/mo
Contract1-year, billed monthly
Setup$3,000–$9,000 onboarding
IncludesMonthly P&L, wound care tracking, DME analysis, provider reports

Is This Right for You?

This service is for podiatry practice owners who recognize these problems:

Medicare is 40% of your revenue and reimbursements keep declining but your cost structure has not changed to match
DME (custom orthotics) should be a profit center but between the lab costs, casting time, and insurance billing, you are not sure what your margin actually is
You see wound care patients multiple times a week for months and the revenue per visit is low but the aggregate revenue per patient should be high. You have no way to see it
Your PA or NP generates revenue but you are not sure it covers their fully loaded cost when you include supervision time
You have two offices and your accountant gives you one combined P&L that tells you nothing about which location is carrying the other

Need strategic financial leadership? Our Fractional CFO service for podiatry practices may be a better fit.

What's Included

How We Work With Podiatry Practices

Podiatry-specific accounting that goes beyond reconciliation.

01

Medicare Revenue & Reimbursement Tracking

  • Medicare reimbursement rate tracking by CPT code
  • Medicare vs commercial profitability comparison
  • MIPS quality measure compliance tracking
  • Medicare patient volume and revenue trend analysis
02

DME & Orthotics Economics

  • Custom orthotic cost per pair (lab, materials, provider time)
  • DME margin analysis by product type
  • Insurance billing success rate for orthotics
  • Inventory and vendor cost tracking
03

Wound Care Program Financials

  • Revenue per wound care patient (full treatment episode)
  • Visit frequency and duration tracking
  • Supply cost per wound care visit
  • Wound care staffing cost analysis
04

Multi-Location & Provider Analysis

  • Per-location P&L with overhead allocation
  • Provider productivity and revenue comparison
  • Mid-level provider cost-benefit analysis

Results

What Podiatry Practices Experience

MetricTypical Outcome
PA restructuringAdjusted schedule and panel to generate $217K in collections, turning -$30K into +$35K annual contribution
Wound care coding$42,000 in additional annual revenue from proper code selection
Orthotic denial reduction$28,000 recovered through documentation improvement and denial resubmission

Case Study

See The System In Action

2-podiatrist practice with one PA, two locations, significant wound care and diabetic patient base. Revenue was $1.1M but had been flat for four years despite adding a PA two years ago. The owner assumed Medicare rate cuts were to blame but had not analyzed the real drivers.

What we found:

  • The PA was generating $165K in collections but costing $195K when fully loaded (salary, benefits, supervision time, malpractice). A net drag of $30K per year that was invisible in combined financials
  • Wound care debridement was coded as 97597 (first 20 sq cm) on 92% of cases, even when wound sizes documented in the chart supported higher-level codes. An estimated $42K per year went uncollected
  • Custom orthotics were billed to insurance 180 times per year but denied 34% of the time due to documentation gaps. Recovered denials represented $28K in revenue
  • Diabetic LOPS foot exams (G0245 initial / G0246 follow-up) were missing the required vascular assessment documentation on 45% of charts, creating compliance risk and denial vulnerability

The results

Adjusted schedule and panel to generate $217K in collections, turning -$30K into +$35K annual contribution

PA restructuring

$42,000 in additional annual revenue from proper code selection

Wound care coding

$28,000 recovered through documentation improvement and denial resubmission

Orthotic denial reduction

I blamed Medicare for our flat revenue. Turns out we were leaving $70K on the table in wound care coding and orthotic denials alone — and our PA was actually costing us money.

Practice Owner, Mid-Atlantic

Common Questions About Accounting for Podiatry Practices

Don't pay for reports. Pay for progress.

Take the 4-minute financial assessment—and find out if your books are helping or hurting your podiatry practice.

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The test your accountant hopes you skip.