To bill Medicare as a supplier of durable medical equipment, prosthetics, orthotics, and supplies, you need to complete Medicare DMEPOS supplier enrollment: get a National Provider Identifier for each location, earn accreditation from a CMS-approved organization, post a $50,000 surety bond and carry at least $300,000 in liability insurance for each site, submit the CMS-855S application through PECOS, and pass an unannounced site inspection. The full process usually takes several months, and small paperwork errors can add weeks or trigger a denial.
Start With an NPI and Accreditation
Before you can file the enrollment application, you need a National Provider Identifier for each practice location. NPIs are issued through the National Plan and Provider Enumeration System, and each is a unique ten-digit number that tracks your transactions in the federal system.1Centers for Medicare & Medicaid Services. Enroll as a DMEPOS Supplier If you already have one from prior healthcare work, you can reuse it, but every additional physical location needs its own.
Accreditation is the real gate. Section 1834(a)(20)(B) of the Social Security Act requires every DMEPOS supplier to be accredited by a CMS-approved organization before Medicare will process an enrollment application.2eCFR. 42 CFR 424.58 – Accreditation The accrediting body evaluates product safety, consumer protections, financial management, and clinical record-keeping, and conducts its own on-site inspection to verify that your location, storage, maintenance logs, and staff training match what you claim.
CMS currently recognizes eight accrediting organizations, including ACHC, ABC, CHAP, HQAA, the Joint Commission, NABP, The Compliance Team, and BOC.3Centers for Medicare & Medicaid Services. DMEPOS Accreditation Organizations Their fees, timelines, and specialties differ. If your business leans heavily toward orthotics and prosthetics, an accreditor focused on that field may fit better than a general one. Choose carefully; the relationship lasts for years.
Who Doesn’t Need Accreditation
Certain professionals who furnish DMEPOS items to their own patients as part of treatment are exempt under Section 154(b)(F) of the Medicare Improvements for Patients and Providers Act of 2008. The exempt categories include physicians, physical therapists, occupational therapists, nurse practitioners, physician assistants, clinical nurse specialists, audiologists, and speech-language pathologists.4Centers for Medicare & Medicaid Services. DMEPOS Accreditation Orthotists, prosthetists, and opticians are also exempt as “other persons” under the same statute. These same professionals are also released from the 30-hour public access rule and the ban on sharing a location with another Medicare provider.5eCFR. 42 CFR 424.57 – Special Payment Rules for Items Furnished by DMEPOS Suppliers and Issuance of DMEPOS Supplier Billing Privileges The exemption is narrow. It applies only when the professional furnishes items to their own patients as part of professional service; a standalone equipment company cannot claim it, regardless of ownership.
Post the Bond and Insurance
Every DMEPOS supplier must post a surety bond of at least $50,000 for each NPI.1Centers for Medicare & Medicaid Services. Enroll as a DMEPOS Supplier A company with three practice locations needs three separate bonds totaling $150,000. The bond has to come from a surety company that holds a Certificate of Authority from the U.S. Department of the Treasury.5eCFR. 42 CFR 424.57 – Special Payment Rules for Items Furnished by DMEPOS Suppliers and Issuance of DMEPOS Supplier Billing Privileges Suppliers with a history of adverse actions, such as prior revocations, may be required to post more than the $50,000 floor. CMS does not publish a fixed schedule for elevated bonds; the enrollment contractor sets the amount based on the supplier’s risk profile.
You also need comprehensive general liability insurance of at least $300,000 covering your place of business, customers, and employees. If you manufacture your own items, the policy must include product liability and completed operations coverage. Professional liability alone does not qualify. Submit a Certificate of Insurance with the coverage amount, effective dates, and covered locations, and name the National Supplier Clearinghouse as the certificate holder.
Letting the policy lapse after enrollment triggers automatic revocation retroactive to the lapse date. Every claim you submitted in that window becomes an overpayment you owe back. Put renewal reminders on the calendar well before the expiration.
File the CMS-855S Through PECOS
The CMS-855S is the enrollment application specific to DMEPOS suppliers. It asks for detailed information about your business, including every individual or entity with a 5% or greater ownership stake, all managing employees, and any history of legal or financial sanctions against those individuals. Inaccurate or incomplete ownership disclosures are one of the quickest routes to a denial.
You also disclose every practice location, your product categories, and applicable state licenses. State licensing rules vary, and you need the appropriate credentials in every state where you plan to furnish items. Missing a required state license will block your enrollment.
CMS strongly prefers electronic submission through the Provider Enrollment, Chain, and Ownership System (PECOS). PECOS is paperless and generally processes faster than a mailed CMS-855S.6Centers for Medicare & Medicaid Services. Enrollment Applications Attach digital copies of the surety bond, insurance certificate, state licenses, and a signed certification statement attesting to the accuracy of everything you filed. Missing attachments are the most common cause of processing delays.
An application fee is due at submission. For 2026, that fee is $750, and the same amount applies to initial enrollment, revalidation, adding a location, or reactivation.7Centers for Medicare & Medicaid Services. PECOS Fee Payment
Pass the Unannounced Site Visit
After the contractor reviews your paperwork, an inspector shows up unannounced during normal business hours. DMEPOS suppliers are classified as moderate-to-high risk, so the visit is mandatory for initial enrollment, revalidation, and any time you add a location.8Centers for Medicare & Medicaid Services. Provider Enrollment Site Visits The inspector confirms that signage is visible, the location is accessible, inventory is physically on-site, and the business is genuinely operational.
Applicants fail here more often than they expect. A locked storefront during posted hours, empty shelves, or signage that does not match the business name on the application counts as a failed visit. You usually get a chance to fix the problem and reschedule, but it adds weeks. Once the inspector clears the facility, the contractor issues final approval and assigns a Provider Transaction Access Number (PTAN). The PTAN is what lets you start submitting claims.
Physical Location Standards
Your facility must be open to the public at least 30 hours per week, display visible signage with posted hours, and be accessible during those hours.5eCFR. 42 CFR 424.57 – Special Payment Rules for Items Furnished by DMEPOS Suppliers and Issuance of DMEPOS Supplier Billing Privileges You need a primary business telephone listed under the business name in a local directory or through a toll-free number reachable via directory assistance. These rules exist to keep shell operations out of the program. DMEPOS suppliers generally cannot share a practice location with another Medicare provider or supplier, aside from the narrow exceptions for physicians, therapists, and other eligible professionals described earlier.
Staying Enrolled After Approval
Enrollment is not a one-time task. You must revalidate every three years by submitting a complete updated application and paying the current fee. You also have to report any change to information on your enrollment record within 30 days, including changes to ownership, practice location, contact information, licensure, and product or service offerings.9Centers for Medicare & Medicaid Services. Requirement to Report DMEPOS Licensure, Product, and Service Changes The regulation is broad and covers every change on the record, not only the big ones. Report changes through PECOS or by filing an updated CMS-855S.
If CMS finds a violation of any supplier standard, whether a lapsed insurance policy, loss of accreditation, a false statement, or another failure, it can revoke your billing privileges. Revocation carries a reenrollment bar of at least one year and up to ten. If CMS decides you tried to work around the bar by enrolling under a different name or identity, it can add up to three years. A second revocation can produce a bar of up to 20 years.10eCFR. 42 CFR 424.535 – Revocation of Enrollment in the Medicare Program For accreditation or licensure lapses, revocation is retroactive to the date the credential was lost, not the date CMS discovered it.
If You’re Denied or Revoked
A denial or revocation letter is not the end. Within 35 days you can submit a Corrective Action Plan that addresses the specific deficiencies identified in the letter. A CAP is not a formal appeal; it is a chance to fix and resubmit. When the problem is missing documentation or a correctable compliance gap, a CAP is usually the fastest path back.
If a CAP is not appropriate or gets rejected, you can request a formal reconsideration. If that goes against you, the next step is a hearing before an Administrative Law Judge through the Office of Medicare Hearings and Appeals, filed within 60 days of the reconsideration decision.11U.S. Department of Health & Human Services. FAQs – Requesting an ALJ Hearing Further review is available through the Medicare Appeals Council and then in federal district court. Billing privileges stay suspended while the appeal runs, which is why keeping insurance current, reporting changes on time, and maintaining accreditation cost far less than any fight to reverse a revocation.