(CMA) — The Commonwealth Medicaid Agency is proudly advancing access to essential healthcare services with the issuance of Administrative Directive No. CMA2025-059, clarifying and expanding coverage for podiatry services under the CNMI Medicaid State Plan. This action reflects CMA’s proactive leadership in addressing preventable health conditions while strengthening support for healthcare providers across the Commonwealth. The directive is effective Dec. 24, 2025.
“Too often, foot and ankle conditions are treated only after they become emergencies,” said George Cruz, the CMA director. “This policy is about changing that reality. It’s about prevention, dignity, and ensuring our people receive care before small problems become life-altering ones.”
Foot and ankle care — especially for individuals living with diabetes, vascular disease, and chronic conditions — is critical to preventing infections, hospitalizations, and amputations. National health organizations consistently emphasize the importance of timely podiatric care as a cornerstone of preventive medicine.
The American Diabetes Association has long noted that early foot evaluation and ongoing preventive care significantly reduce the risk of serious complications and lower-extremity amputations among people with diabetes. Similarly, national podiatric organizations have emphasized that integrating podiatry into covered medical services improves mobility, preserves independence, and reduces avoidable healthcare costs.
According to the 2023 CNMI Non-Communicable Disease & Risk Factory Adult Hybrid Survey, 55% of participants who took the survey were on Medicaid. That same report stated that approximately 26.8% of adults in the CNMI were estimated to have diabetes and about 29.4% of CNMI adults were estimated to having pre-diabetes.
How the policy works
Under CMA’s updated guidance, podiatry services are recognized as covered physician services when performed by licensed medical doctors or doctors of osteopathy, or when provided under the personal supervision of a licensed physician, consistent with federal Medicaid regulations and CNMI law. Covered services include evaluation, diagnosis, treatment, and medically necessary preventive foot care, particularly for high-risk patients.
These services are reimbursed under the existing physician services fee schedule, ensuring clarity, consistency, and sustainability for providers while expanding access for beneficiaries.
Benefits for providers and beneficiaries
For providers, this directive brings long-needed clarity and stability — supporting appropriate reimbursement, reducing administrative uncertainty, and strengthening participation in the Medicaid program. For beneficiaries, it means earlier intervention, fewer emergency room visits, and better long-term health outcomes.
A vision for the future
Director Cruz emphasized that this directive is part of a broader transformation underway at CMA.
“We are being intentional and forward-looking,” Cruz said. “This clarification allows us to immediately expand access under our existing state plan, while we actively work on long-term solutions — such as state plan amendments — to permanently strengthen coverage for podiatry services and other critical healthcare needs in our community.”
Investing in health, mobility, and quality of life
By prioritizing preventive foot care, CMA is helping beneficiaries stay mobile, independent, and engaged in their families and communities, while reducing costly complications that strain the healthcare system.
This initiative underscores CMA’s commitment to expanding services, strengthening provider partnerships, and building a healthier future for the Commonwealth.
“Our goal is simple but powerful: a Medicaid program that is responsive, compassionate, and built for the real health challenges facing the CNMI today and tomorrow,” Cruz said.
For additional information, providers and beneficiaries may contact the CMA at (670) 664-4880, email info@cnmimedicaid.org or visit www.cnmimedicaid.org/.
