State DME licenses renew on different schedules: Virginia by February 28, Mississippi June 30, Georgia June 30 every third year, Ohio June 30 of even years, Alabama and Louisiana August 31, North Carolina December 31, and Tennessee on each license's anniversary. Missing the grace period in several states means a new application and inspection.
A supplier licensed in several states is never far from a deadline. Each state sets its own cycle, its own due date and its own consequence for missing it, and the consequences escalate quickly: a late fee, then a lapse, then in several states a brand-new application and inspection. Medicare adds its own clocks on top. Below is the calendar for the states we have verified, as of October 2026, with the rule behind each date.
Which state licenses renew when?
| State | Cycle and due date | Late window and consequence | Source |
|---|---|---|---|
| Virginia (in-state permit) | Annual, due by February 28 ($350) | $80 late fee within one year; operating after expiration is grounds for discipline | 18VAC110-20-20 |
| Virginia (nonresident registration) | Annual, by March 1 | Fee set by Board regulation | Va. Code 54.1-3435.3:1 |
| Mississippi | Annual, expires June 30 | $100 late fee after June 30; void if not received by September 30 | Miss. Code 73-21-108(2)(e) |
| Georgia | Every 36 months, expires June 30 of every third year ($600) | Lapses if not renewed before September 1 of the renewal year; $900 late fee; reinstatement at the Board's discretion | Ga. Comp. R. & Regs. 480-7B-.02(4); Board fee schedule |
| Ohio | Biennial, by June 30 of each even-numbered year (next: June 30, 2028) | $200 late fee; void if not filed by the 61st day | Ohio Admin. Code 4729:11-2-01(D)-(F) |
| Alabama | Annual, expires August 31 ($250) | Renew within 60 days with a $150 late fee; after that the license lapses and a new application and inspection are required | Ala. Admin. Code 473-X-8-.01 |
| Louisiana | Annual, expires August 31 ($200) | $100 delinquent renewal fee; reinstating an expired permit takes a completed application plus the renewal and $200 reinstatement fees | La. Admin. Code tit. 46, LIII-2403, LIII-115 |
| North Carolina | Annual, expires December 31 ($200) | Invalid 60 days after expiration; after March 31, a new application at the $500 original fee | 21 NCAC 46 .1609, .1612 |
| Tennessee | Annual, on the anniversary of original issue ($1,404) | Within 60 days, $100 per month late penalty capped at twice the fee; after 60 days, reapply and be inspected | Tenn. Comp. R. & Regs. 0720-30-.02(1)(c), (4) |
| California | Annual ($1,584 in state; $280 out of state) | $10 late fee on the out-of-state registration when more than 30 days past expiration | Health & Safety Code 111656(a), 111656.8(d); CDPH 8679O |
| Florida | Biennial ($304.50 per location) | Renewal may also carry the $400 inspection fee if an inspection is required | Fla. Admin. Code 59A-25.002(3) |
| Illinois | Set by IDFPR rule; renewal calculated at $100 per year | Act scheduled for repeal January 1, 2028 | 225 ILCS 51/50; 68 Ill. Adm. Code 1253.70 |
| Indiana | Biennial ($200) | Check the Board's renewal notice for the date | 856 IAC 1-39-7 |
| Pennsylvania | Annual registration ($25 for devices) | Late fees accrue monthly once the business is notified | 28 Pa. Code 25.113, 25.115 |
Two patterns stand out. First, the "statewide date" states (Virginia, Mississippi, Georgia, Ohio, Alabama, Louisiana, North Carolina) bunch renewals at the end of February, the end of June, the end of August and the end of December. Second, Tennessee runs on each license's own anniversary, so a supplier that opened Tennessee licenses at different times has different Tennessee dates. A calendar built by state alone will miss that.
When does a late renewal become a new application?
This is the line to plan around, because a new application usually means a new inspection, new fees and a period without a valid license:
- Alabama: after the 60-day window, "a cease and desist letter will be issued" and "a new application and inspection will be required," and from November 1 the Board may tell Medicare, Medicaid and other payers about lapsed licenses (473-X-8-.01(7)-(8)).
- Tennessee: after the 60-day grace period, reapply with the license fee and "submit to an inspection" (0720-30-.02(4)).
- North Carolina: "After March 31, permits and registrations issued to locations shall submit new applications and are subject to the maximum original registration fees" (.1612(a)).
- Georgia: no renewal after September 1 of the third year; reinstatement "is at the sole discretion of the Board" (480-7B-.02(4)).
- Ohio: after the 60th day, the license or registration "is considered void and cannot be renewed," though the holder may reinstate under Board procedures (4729:11-2-01(F)(6)).
- Mississippi: void if the renewal and late fee are not in by September 30 (73-21-108(2)(e)).
Why does a lapse cost more than the late fee?
Because of Medicare. The supplier standards require compliance with state licensure for the items you furnish (42 CFR 424.57(c)(1)(ii)), and CMS's fact sheet says that if a supplier violates a standard, "like not being appropriately licensed," the enrollment contractors "may deny enrollment or revoke Medicare billing privileges." Competitive bidding raises the stakes again: CBIC requires licenses to be "current and non-expired in PECOS" by the close of the bid window, through bid evaluation and, for contract suppliers, "through the entire DMEPOS CBP contract performance period." A license that lapses mid-contract is a contract problem. See getting your state licenses into PECOS.
What other dates belong on the same calendar?
- Accreditation: "All accredited DMEPOS suppliers must be surveyed and reaccredited at least once every 12 months" (42 CFR 424.57(c)(24)). Surveys are unannounced, so the date to track is your accreditation anniversary, not a survey appointment. See annual reaccreditation.
- Medicare revalidation: "A supplier must revalidate its application for billing privileges every 3 years after the billing privileges are first granted" (424.57(g)). See DMEPOS revalidation.
- Changes: the supplier "must report to CMS any changes in information supplied on the application within 30 days" (424.57(c)(2)), including a new or renewed license the contractor needs to see.
- Insurance and bond: state applications often ask for current liability insurance (Alabama requires at least $300,000; Florida $250,000 per claim), so policy renewal dates belong next to license dates.
- Named people: designated representative, exemptee and person-in-charge credentials, such as California's $280 annual exemptee renewal. See designated representatives and exemptees.
How do we track renewals?
License Renewal Tracking is $299 per license, per year (pricing). We keep each license, its state's rule and its own date (including Tennessee anniversaries), start each renewal early enough to beat the late window, prepare the renewal forms and attachments, and upload the renewed license for your PECOS record. Your owner or officer signs and pays each state; renewals done in a state's online portal are done in your account. For the full list of verified states, see DME license requirements by state.
Common questions
- When do most state DME licenses expire?
- There is no common date. Of the states we verified, Virginia's in-state permit renews by February 28, Mississippi's expires June 30, Alabama's and Louisiana's August 31, North Carolina's December 31, Georgia's June 30 every third year and Ohio's June 30 of even years. Tennessee uses each license's anniversary.
- What happens if I miss a DME license renewal?
- Usually a late fee first, then a lapse. Alabama, Tennessee and North Carolina require a new application, and Alabama and Tennessee a new inspection, once their grace periods pass. Operating on a lapsed license also puts your Medicare billing privileges at risk.
- Does Medicare check that my state licenses are current?
- Yes. State licensure is a supplier standard, and CMS says suppliers that are not appropriately licensed can be denied or revoked. For competitive bidding, licenses must stay current in PECOS through the contract period.
- How often do DMEPOS suppliers revalidate and reaccredit?
- Medicare revalidation is every 3 years (42 CFR 424.57(g)), and accredited suppliers must be surveyed and reaccredited at least once every 12 months (424.57(c)(24)).
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