Form Approved
DEPARTMENT OF HEALTH AND HUMAN SERVICES OMB No. 0938-1056
CENTERS FOR MEDICARE & MEDICAID SERVICES
Expires: 12/31/2025
DMEPOS SUPPLIER STANDARDS FOR MEDICARE ENROLLMENT
Below is an abbreviated summary of the standards every Medicare DMEPOS supplier must meet in order to obtain and
retain their billing privileges. These standards, in their entirety, including the surety bond provisions, are listed in 42 C.F.R.
section 424.57(c) and (d) and can be found at:
CMS.gov/medicare/provider-enrollment-and-certification/enroll-as-a-dmepos-supplier.
1. A supplier must be in compliance with all applicable
federal and state licensure and regulatory
requirements.
2. A supplier must provide complete and accurate
information on the DMEPOS supplier application. Any
changes to this information must be reported to the
contractor within 30 days.
3. A supplier must have an authorized individual whose
signature is binding sign the enrollment application for
billing privileges.
4. A supplier must fill orders from its own inventory or
contract with other companies for the purchase of
items necessary to fill orders. A supplier cannot contract
with any entity that is currently excluded from the
Medicare program, any state health care programs, or
any other federal procurement or non-procurement
programs.
5. A supplier must advise beneficiaries that they may rent
or purchase inexpensive or routinely purchased durable
medical equipment, and of the purchase option for
capped rental equipment.
6. A supplier must notify beneficiaries of warranty
coverage and honor all warranties under applicable
state law, and repair or replace free of charge Medicare
covered items that are under warranty.
7. A supplier must maintain a physical facility on an
appropriate site and must maintain a visible sign
with posted hours of operation. The location must be
accessible to the public and staffed during posted hours
of business. The location must be at least 200 square
feet and contain space for storing records.
8. A supplier must permit CMS or its agents to conduct
on-site inspections to ascertain the supplier’s
compliance with these standards.
9. A supplier must maintain a primary business telephone
listed under the name of the business in a local
directory or a toll free number available through
directory assistance. The exclusive use of a beeper,
answering machine, answering service or cell phone
during posted business hours is prohibited.
10. A supplier must have comprehensive liability insurance
in the amount of at least $300,000 that covers both
the supplier’s place of business and all customers and
employees of the supplier. If the supplier manufactures
its own items this insurance must also cover product
liability and completed operations.
11. A supplier is prohibited from direct solicitation to
Medicare beneficiaries. For complete details on this
prohibition see 42 C.F.R. section 424.57(c)(11).
12. A supplier is responsible for delivery of and must
instruct beneficiaries on the use of Medicare covered
items, and maintain proof of delivery and beneficiary
instruction.
13. A supplier must answer questions and respond
to complaints of beneficiaries and maintain
documentation of such contacts.
14. A supplier must maintain and replace at no charge or
repair cost either directly or through a service contract
with another company, any Medicare-covered items it
has rented to beneficiaries.
15. A supplier must accept returns of substandard (less than
full quality for the particular item) or unsuitable items
(inappropriate for the beneficiary at the time it was
fitted and rented or sold) from beneficiaries.
16. A supplier must disclose these standards to each
beneficiary it supplies a Medicare-covered item.
17. A supplier must disclose any person having ownership,
financial or control interest in the supplier.
18. A supplier must not convey or reassign a supplier
number; i.e., the supplier may not sell or allow another
entity to use its Medicare billing number.
19. A supplier must have a complaint resolution protocol
established to address beneficiary complaints that
relate to these standards. A record of these complaints
must be maintained at the physical facility.
20. Complaint records must include: the name, address,
telephone number and Medicare Beneficiary Identifier
of the beneficiary, a summary of the complaint, and
any actions taken to resolve it.
21. A supplier must agree to furnish CMS any information
required by the Medicare statute and regulations.
22. A supplier must be accredited by a CMS-approved
accreditation organization in order to receive and
retain a supplier billing number. The accreditation must
indicate the specific products and services for which
the supplier is accredited in order for the supplier to
receive payment for those specific products and services
(unless an exception applies).
23. A supplier must notify their accreditation organization
when a new DMEPOS location is opened.
24. All supplier locations, whether owned or subcontracted,
must meet the DMEPOS quality standards and be
separately accredited in order to bill Medicare.
25. A supplier must disclose upon enrollment all products
and services, including the addition of new product
lines for which they are seeking accreditation.
26. A supplier must meet the surety bond requirements
specified in 42 C.F.R. section 424.57(d) (unless an
exception applies).
27. A supplier must obtain oxygen from a state-licensed
oxygen supplier.
28. A supplier must maintain ordering and referring
documentation consistent with provisions found in 42
C.F.R. section 424.516(f).
29. A supplier is prohibited from sharing a practice location
with other Medicare providers and suppliers.
30. A supplier must remain open to the public for a
minimum of 30 hours per week except physicians (as
defined in section 1848(j) (3) of the Act), physical and
occupational therapists or DMEPOS suppliers working
with custom made orthotics and prosthetics.
CMS-855S (12/23) 1