Medicare 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).

1.  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 licensed services.

2. 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.

3. An authorized individual (one whose signature is binding) must sign the application for billing privileges.

4. 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 health care programs, or from any other Federal procurement or non-procurement

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. 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 records.

8. 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.

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 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.

12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and
maintain proof of delivery.

13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such

14. 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 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 supplier standards to each beneficiary to whom it supplies a Medicare-covered item.

17. A supplier must disclose to the government any person having ownership, financial, or control interest in the

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 health insurance claim number 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 implementing

22. 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

23. All suppliers 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. All suppliers must disclose upon enrollment all products and services, including the addition of new product lines
for which they are seeking accreditation.

26. Must meet the surety bond requirements specified in 42 C.F.R. 424.57(c). Implementation date- May 4, 2009

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.

29. DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and

30. DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions.