Note: This is an abbreviated version of the supplier standards every Medicare DMEPOS supplier
must meet in order to obtain and retain their billing privileges. These standards, in their
entirety, are listed in 42 C.F.R. 424.57(c).
Medicare dmepos supplier standards
- A supplier must be in compliance with all applicable Federal and State licensure and
regulatory requirements and cannot contract with an individual or entity to provide
- A supplier must provide complete and accurate information on the DMEPOS supplier
application. Any changes to this information must be reported to the National Supplier
Clearinghouse within 30 days.
- An authorized individual (one whose signature is binding) must sign the application for
- A supplier must fill orders from its own inventory, or must contract with other
companies for the purchase of items necessary to fill the order. A supplier may not
contract with any entity that is currently excluded from the Medicare program, any State
healthcare programs, or from any other Federal procurement or non-procurement programs.
- 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
- 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.
- A supplier must maintain a physical facility on an appropriate site. This standard
requires that the location is 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
- A supplier must permit CMS, or its agents to conduct on-site inspections to ascertain
the supplier’s compliance with these standards. The supplier location must be accessible
to beneficiaries during reasonable business hours, and must maintain a visible sign and
posted hours of operation.
- 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.
- A supplier must have comprehensive liability insurance in the amount of at least
$300,000 that covers both the supplier’s place of business an all customers and
employees of the supplier. If the supplier manufactures its own items, this insurance
must also cover product liability and completed operations.
- A supplier must agree not to initiate telephone contact with beneficiaries, with a few
exceptions allowed. This standard prohibits suppliers from contacting a Medicare
beneficiary based on a physician’s oral order unless an exception applies.
- A supplier is responsible for delivery and must instruct beneficiaries on use of
Medicare covered items, and maintain proof of delivery.
- A supplier must answer questions and respond to complaints of beneficiaries, and
maintain documentation of such contacts.
- A supplier must maintain and replace at no charge or repair directly, or through a
service contract with another company, Medicare covered items it has rented to
- 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.
- A supplier must disclose these supplier standards to each beneficiary to whom it
supplies a Medicare covered item.
- A supplier must disclose to the government any person having ownership, financial, or
control interest in the supplier.
- 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.
- 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.
- Complaint records must indicate: the name, address, telephone number and health
insurance claim number of the beneficiary, a summary of the complaint, and any actions
taken to resolve it.
- A supplier must agree to furnish CMS any information required by the Medicare statute
and implementing regulations.
- All suppliers 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 of those specific products and services (except for certain
exempt pharmaceuticals). Implementation Date – October 1, 2009
- All suppliers must notify their accreditation organization when a new DMEPOS location is
- All supplier locations, whether owned or subcontracted, must meet the DMEPOS quality
standards and be separately accredited in order to bill Medicare.
- All suppliers must disclose upon enrollment all products and services, including the
addition of new product lines for which they are seeking accreditation.
- Must meet the surety bond requirements specified in 42 C.F.R. 424.57(c). Implementation
date – May 4, 2009.
- A supplier must obtain oxygen from a state-licensed oxygen supplier.
- A supplier must maintain ordering and referring documentation consistent with provisions
found in 42 C.F.R. 424.516(f).
- DMEPOS suppliers are prohibited from sharing a practice location with certain other
Medicare providers and suppliers.
- DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with