MEDICARE DMEPOS SUPPLIER STANDARDS
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).
- A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.
- 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.
- A supplier must have an authorized individual (whose signature is binding) sign the enrollment application for billing
privileges.
- 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 may not 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.
- 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.
- 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 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.
- A supplier must permit CMS or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these
standards.
- 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 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.
- A supplier is prohibited from direct solicitation to Medicare beneficiaries. For complete details on this prohibition see 42 CFR
§ 424.57 (c) (11).
- 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.
- 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 cost either directly, or through a service contract with another
company, any Medicare-covered items it has rented to beneficiaries.
- 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 standards to each beneficiary it supplies a Medicare-covered item.
- A supplier must disclose 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.