Each new DME location that furnishes Medicare items is enrolled separately, with its own NPI, PTAN and CMS-855S, an additional $50,000 bond or rider, state licenses where required and its own accreditation survey. Since January 1, 2026, a new location must be surveyed before it is accredited; temporary accreditation is gone. Warehouses are exempt.
A growing DME company usually thinks of a second location as more of the same: another lease, more staff, more inventory. Medicare treats it as a new supplier in most of the ways that matter. The supplier standards say "the supplier must enroll separate physical locations it uses to furnish Medicare-covered DMEPOS, with the exception of locations that it uses solely as warehouses or repair facilities," and "CMS issues only one supplier number for each location" (42 CFR 424.57(b)). A new location needs its own enrollment, and most of the steps that came before the first one.
Which locations need their own enrollment?
Any physical location that furnishes Medicare-covered DMEPOS: a storefront, a fitting site, a branch that patients visit. A location used only as a warehouse or repair facility is the exception. If a warehouse starts handling patients, it stops being an exception. Each enrolled location must meet the location standards on its own: at least 200 square feet, publicly accessible, staffed during posted hours, a permanent sign, a primary phone at the site, open at least 30 hours a week, and not shared with another Medicare provider or supplier except as the rules allow (424.57(c)(7), (9), (29) and (30)).
What does the new location need, in order?
- An NPI for the location. The CMS-855S says each business location must have its own NPI unless the supplier is a sole proprietor with multiple locations.
- A compliant site, leased and set up as above. See what the site inspector checks.
- State licenses. State DME licenses are usually per location. California licenses each premises separately; Georgia requires a separate application for each place of business and its licenses are location-specific. A location in a new state may need that state's license before anything else.
- Insurance covering the new place of business; Medicare's minimum is $300,000 (424.57(c)(10)).
- Accreditation for the location. Every location, owned or subcontracted, must be separately accredited (424.57(c)(22)), and you must notify your accrediting organization when a new location opens (424.57(c)(23)). Since January 1, 2026, CMS's MLN905710 says, "all existing DMEPOS suppliers who have a new location must be surveyed before being accredited," which ended the 90-day temporary accreditation that new locations once relied on.
- Bond coverage. A supplier enrolling a new practice location must submit a new surety bond, or a rider to the existing one, showing the location is covered by an additional $50,000 base bond, or more if elevated amounts apply (424.57(d)(2)(iii)).
- The CMS-855S for the location, with the application fee, which applies to new practice locations ($750 in calendar 2026, CMS-6096-N).
- Screening and the site visit, then the PTAN for the location.
Why does accreditation now set the pace?
Because the location cannot be accredited until it is surveyed, and it cannot enroll until it is accredited. Before 2026, an accredited supplier could often open a location under temporary accreditation and be surveyed later. The calendar 2026 home health final rule (CMS-1828-F) removed that. Plan for the location to be fully operational, staffed, stocked and compliant before the survey, with rent running and no Medicare billing from that site yet. Annual resurvey (424.57(c)(24)) then applies to the location along with the rest of the company. See annual reaccreditation.
Can a moratorium stop a new location?
Yes. A CMS moratorium can cover "the establishment of new practice locations of a particular type" (42 CFR 424.570(a)(1)(i)). The 2026 moratorium on medical supply companies did exactly that from February 27 to August 27, 2026: CMS said that because each location enrolls separately, "enrolling a new location is considered an initial enrollment." A relocation is different; the rules exclude changes in practice location (except moving into a moratorium area). See the 2026 moratorium.
How is a new location different from a move?
A move replaces one enrolled location with another and is reported as a change of information within 30 days (424.57(c)(2)); CMS's MLN905710 lists a change in practice location among the changes to report. Tell your accrediting organization about a move as well. A new location adds an enrollment. Medicaid programs draw the same line: New York says an additional operating location "cannot be added to an existing provider service address unless it is a result of an address change," and needs its own NPI and enrollment. See the 30-day rule.
What about Medicaid and private payers for the new site?
Each typically needs to know about, and approve, the new location separately. Texas Medicaid says providers in its moderate or high risk categories "cannot render or submit claims for services at a new practice location until it has been approved and added to the enrollment record," and its DME surety bond is required for each enrolled location. Check each plan contract for how it adds locations, and update any network manager. See Medicaid DME enrollment.
Does a new location change competitive bidding?
For Round 2028, only locations listed on a bid, identified by PTAN, are evaluated, and only locations on a contract may bill for competitively bid items. A contract supplier can later ask to add a location through a change of location request in Connexion, and CBIC says a location can be added if it meets all enrollment requirements and is licensed in at least one state in the nationwide area. A new location enrolled before the bid window closes can also carry state licenses for the bid. See the licensing deadline.
How do we help with a new location?
Our Additional Location Enrollment is $595 per location: the 855S for the new site, prepared for your authorized official to sign and submitted in PECOS once your official approves us as a surrogate, plus the bond rider documents for your surety agent and site-visit readiness against the supplier standards. State licenses for the location are $699 ($899 in California, Florida, Georgia and Alabama). Annual Survey Readiness ($1,200 a year) keeps every location ready for its unannounced resurvey. You pay the CMS fee, state fees, accreditation fees and bond premium directly. No one can promise a PTAN by an opening date, so build the gap into the lease plan.
Common questions
- Does every DME location need its own Medicare enrollment?
- Yes, except locations used only as warehouses or repair facilities. Under 42 CFR 424.57(b), CMS issues one supplier number per location, so each location enrolls separately.
- Can a new DME location bill while waiting for its accreditation survey?
- No. Since January 1, 2026, CMS says a new location must be surveyed before it is accredited, and the enrollment contractors do not process applications from unaccredited suppliers.
- How much more bond does a new location need?
- An additional $50,000 base bond, through a new bond or a rider to the existing one, or more if elevated amounts apply for adverse legal actions, under 42 CFR 424.57(d)(2)(iii).
- Is moving my store the same as adding a location?
- No. A move is reported as a change of information within 30 days. A new location is a separate enrollment, and a moratorium can block it while a move would usually be allowed.
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