DPM Scope of Practice
Latest Information About Ohio Laws and Regulations
APMA State Reference Manual
Ohio Scope of Practice
Defining Practice of Podiatric Medicine and Surgery
Ohio Revised Code 4731.51
Definition of Foot
Ohio Administrative Code 4731-20-01
Surgical Privileges for the Podiatric Physician & Surgeon
Ohio Administrative Code 4731-20-02 Surgery: ankle joint
Scope of Practice Information
Anti-Fee Discrimination Provision
In a decision released June 19, 2012, the Court of Appeals of Ohio ruled that Ohio law does not prohibit insurers from reimbursing podiatric physicians at a rate less than other physicians. The decision was based on the Court’s ruling that the clear and unambiguous language of the Ohio law at issue was simply to require insurers to pay for covered services furnished by podiatrists. The Court found that the law did not address the amount of reimbursement paid by insurers.
Ohio Podiatric Medical Association, et al. v. Mary Taylor, Director and Superintendent, Ohio Department of Insurance (October 2011)
Anti-Fee Discrimination Provision
Biopsies - Punch and Shave Below the Knee
The State Medical Board of Ohio has determined that it is within the scope of practice for an Ohio podiatric physician to perform punch or shave biopsies of suspicious lesions on the lower leg or hand where the podiatric physician has expertise in performing biopsies. (March 19, 2018)
Bone Graft Harvest from the Proximal Tibia
The State Medical Board of Ohio determined that harvesting of a bone graft from the proximal tibia to be used for foot and ankle surgery is NOT within the podiatric scope of practice as defined in the Ohio Revised Code and Administrative Code. (June 12, 2019)
Bone Marrow Aspirate Harvest from the Proximal Tibia
The State Medical Board of Ohio determined in 2019 that harvesting of bone marrow aspirate is a component of podiatric training, whether in podiatric medical school, residency or continuing education. It is clear that an appropriately trained podiatrist MAY aspirate bone marrow from the foot.
The State Medical Board of Ohio released the following statement in December 2021:
Previously the State Medical Board of Ohio (Board) issued a position statement relative to whether the performing of a supramalleolar osteotomy of the tibia and fibula and the harvest of bone marrow aspirate from the proximal tibia are within the scope of practice of podiatry.
Earlier this year, the State Medical Board of Ohio (Board) began the process of drafting administrative rules relative to this issue. As always, public input is large part of the rule making process. Board staff spent significant time talking with medical professionals and hospital systems regarding the performance of these treatments as well as soliciting additional public input.
Based upon this gathered information, the Board determined that it has acted prematurely in this matter and that additional legislative guidance is necessary. Therefore, the Board is withdrawing its statement on these two procedures. It is our understanding that podiatrists were credentialed to perform these procedures prior to the issuance of the Board’s statement in 2019. It is recommended that providers work with their hospital systems and legal counsel going forward.
External Fixation
On June 11, 2009 the State Medical Board of Ohio approved the Scope of Practice Committee's determination that an Ohio podiatric physician who has successfully completed appropriate training may use and place external fixation apparatus for the relief of foot and ankle pathologies or to surgically correct and immobilize the ankle when the procedure is medically appropriate.
Hand Procedures - Surgical Removal of Warts from the Hands
"Section 4731.51, ORC, states that a podiatrist may treat superficial lesions of the hand other than those associated with trauma. Warts are caused by viruses not trauma. Accordingly, the surgical removal of warts from the hands is within the scope of practice of an appropriately trained podiatric physician when the wart did not result from trauma." (June 12, 2019)
Hand Procedures - Surgical Removal of Ingrown Nails from the Hands
The State Medical Board of Ohio determined that a podiatrist may treat superficial lesions of the hand other than those associated with trauma. "Accordingly, the surgical removal of ingrown nails from the hands is within the scope of practice of a podiatric physician when the ingrown nail did not result from trauma." (June 12, 2019)
History and Physicals In Ambulatory Surgical Centers
A podiatrist may properly perform the pre-admission history and physical on patients scheduled for surgical procedures that are within the podiatrist's scope of practice.
Hospital Privileges And Medical Staff Provision
Substitute House Bill Number 189 in the 125th General Assembly empowered podiatrists who are members of a medical staff to admit a patient to a hospital.
Services that may be rendered by a podiatrist pursuant to section 4731.51 of the Revised Code provided to patients admitted solely for the purpose of receiving such services shall be under the supervision of the admitting podiatrist.
Hyperbaric Oxygen Chamber Therapy
HB 216, which took effect April 6, 2017, added Hyperbaric Oxygen Therapy Supervision provisions to the DPM Scope of Practice in Ohio.
The language in the bill includes the following: Hyperbaric oxygen therapy may be ordered by a podiatrist to treat ailments within the scope of practice of podiatry as set forth in this section and, in accordance with section 4731.511 of the Revised Code, the podiatrist may supervise hyperbaric oxygen therapy for the treatment of such ailments.
Laser Treatment For Hands
The State Medical Board of Ohio determined that an Ohio podiatric physician who has successfully completed appropriate training may, as medically appropriate, provide treatment of fingernail fungus in podiatric patients and for treatment of scars on the hand when the etiology is not associated with trauma.
Medication Reconciliation
The State Medical Board of Ohio affirmed that a podiatric physician does not exceed the podiatric scope of practice by continuing a previously prescribed medication for a medical condition that is not within the podiatric scope of practice. Medication reconciliation does not equate to prescribing or ordering medication. Whether the surgery is inpatient or outpatient, medication reconciliation ensures that all medication previously prescribed for the patient are carried through to the next transition point.
Medical and Physician Assistant Information
Medical Assistants are not a licensed/regulated profession in Ohio, so there are no standards in place for training, education or scope of practice for this profession.
Physician Assistants, on the other hand, are regulated by the Medical Board with educational standards, training requirements, a required national certification examination, and scope of practice defined in Ohio statute and rule in Chapter 4730. Regulation of physician assistants is outlined in Ohio statute and rule in Chapter 4730-1.
A medical assistant cannot practice as a Physician Assistant, please click here for definitions of Delegation of Medical Tasks and click here for a letter from the state medical board outlining medical assistant activities.
Peroneal Nerve Decompression Procedure
The State Medical Board of Ohio affirmed that "an Ohio podiatric physician who has successfully completed appropriate training may perform peroneal nerve decompression for the relief of foot and ankle pathologies, such as diabetic neuropathy, when the procedure is medically appropriate." (September 12, 2007)
Pneumatic Compression Devices
The State Medical Board of Ohio affirmed that "Consistent with these earlier responses, a podiatric physician may provide acute treatment for a venous stasis ulcer associated with chronic venous insufficiency appearing below the knee. A podiatric physician may also treat the post-operative secondary lymphedema associated with a foot or ankle procedure. Finally, a podiatric physician may prescribe a pneumatic compression device for the treatment of the local manifestations of secondary lymphedema or chronic venous insufficiency with venous stasis ulcers so long as the patient is referred for appropriate medical management for the primary medical condition. (September 19, 2011)
Split Thickness Skin Grafts
The State Medical Board of Ohio affirmed that "an appropriately trained podiatric physician may perform split thickness skin grafts whereby skin is harvested from the anterior thigh for grafting to an area below the knee when the procedure is medically appropriate for the treatment of foot and ankle pathologies." (September 12, 2007)
Supramalleolar Osteotomy of the Tibia or Fibula to Correct a Deformity
The State Medical Board of Ohio confirmed that "a supramalleolar ostetomy of the tibia or fibula constitutes ankle surgery, as defined in Rule 4731-20-02, OAC, and is within the podiatric scope of practice of an appropriately trained podiatric physician..." (June 12, 2019)
The State Medical Board of Ohio released the following statement in December 2021:
Previously the State Medical Board of Ohio (Board) issued a position statement relative to whether the performing of a supramalleolar osteotomy of the tibia and fibula and the harvest of bone marrow aspirate from the proximal tibia are within the scope of practice of podiatry.
Earlier this year, the State Medical Board of Ohio (Board) began the process of drafting administrative rules relative to this issue. As always, public input is large part of the rule making process. Board staff spent significant time talking with medical professionals and hospital systems regarding the performance of these treatments as well as soliciting additional public input.
Based upon this gathered information, the Board determined that it has acted prematurely in this matter and that additional legislative guidance is necessary. Therefore, the Board is withdrawing its statement on these two procedures. It is our understanding that podiatrists were credentialed to perform these procedures prior to the issuance of the Board’s statement in 2019. It is recommended that providers work with their hospital systems and legal counsel going forward.
Surgical Procedures
The State Medical Board of Ohio clarified that the performance of tibial or fibular osteotomy, total ankle replacement, and bone callus distraction of the foot and ankle are within the scope of practice of an Ohio podiatric physician when the podiatric physician can demonstrate adequate education, training, and experience needed to conform to minimal standards of care and holds privileges to perform the procedure at a Joint Commission accredited hospital, Ohio licensed ambulatory surgical center, or approved college of podiatric medicine and surgery.
Telemedicine
On March 23, 2022, Ohio’s new telehealth law including R.C. 4743.09 became effective. This new telehealth law applies to the following Medical Board licensees: physicians (MD, DO, DPM), physician assistants, dietitians, respiratory care professionals and genetic counselors.
The new law also allowed the Medical Board to extend its suspension of enforcement of the Board’s current telehealth related rules while the Board amends or adopts new telehealth rules. At its February 9, 2022 meeting, the Medical Board voted to extend the suspension of enforcement of these rules while the Board amends or adopts new telehealth rules.
Venous Leg Ulcers
The State Medical Board of Ohio affirmed that "The required expertise to provide wound care is not dependent upon the site or etiology of the wound as the same knowledge and skills are required whether the site is above or below the ankle and no matter the etiology. For this reason, it is clear that the medical services a podiatric physician may perform include, as medically appropriate, the treatment of foot and ankle pathologies through wound care services applied to wounds that are located below the knee distally".
Vaccination
Section 4731.512 of Ohio Revised Code authorizes a podiatrist to administer the Influenza and COVID-19 vaccine to individuals who are seven years or age or older.
