The 30 DMEPOS Supplier Standards in Plain English

When a supplier signs the CMS-855S, it certifies that it "meets and will continue to meet" the application certification standards in 42 CFR 424.57(c). There are 30 of them. They are not aspirational: CMS "revokes a supplier's billing privileges if it is found not to meet the conditions or standards" (424.57(e)(1)), and the enrollment denial and revocation rules each list non-compliance with any provision of 424.57(c) as its own ground (424.530(a)(18)(ii) and 424.535(a)(23)(ii)).

Below is each standard in plain language, grouped by subject. The numbers follow the regulation. The abbreviated list printed on page 1 of the 855S orders a few of them differently, so cite the regulation when it matters.

Which standards cover licensing and honesty on the application?

1. Standard 1: comply with federal and state law. That includes federal accessibility requirements and state licensure. "If a State requires licensure to furnish certain items or services, a DMEPOS supplier ... Must be licensed to provide the item or service," though it may contract with a licensed individual or entity unless state law forbids it. The state license requirements page tracks what each state requires.
2. Standard 2: no false statements, and report changes within 30 days. "The supplier must report to CMS any changes in information supplied on the application within 30 days of the change." See the 30-day rule.
3. Standard 3: the application is signed by someone whose signature binds the supplier. In practice, the authorized official (424.510(d)(3)).
4. Standard 17: comply with the ownership disclosure rules in 42 CFR 420.206.
5. Standard 21: give CMS, on request, any information the Medicare statute and regulations require.

What does the physical location have to look like?

Standard 7 is the one site inspectors test most directly. An appropriate site must:

• be a practice location of at least 200 square feet, unless the supplier is state-licensed orthotic and prosthetic personnel (or practicing in a state without O&P licensure) providing custom-fabricated items in private practice;
• be accessible to the public, Medicare beneficiaries, CMS and its agents, and not in a gated community or other restricted area;
• be accessible and staffed during posted hours;
• have a permanent visible sign in plain view with posted hours (in a building complex, the sign must be visible at the main entrance or the hours posted at the supplier's entrance);
• have space for business records and for the ordering and referring documentation required by 424.516(f), unless a multisite supplier keeps records at a central location.

A site may be a "closed door" business, such as a pharmacy or a supplier serving only nursing home residents, if it otherwise meets the standard. Related rules:

• Standard 8: permit on-site inspections by CMS and its agents.
• Standard 9: a primary business telephone operating at the site and listed under the business name, locally or toll-free. A cell phone, beeper or pager cannot be the primary line; calls cannot be forwarded exclusively to one; and answering machines or services cannot be used exclusively during posted hours.
• Standard 29: no shared practice location with another Medicare provider or supplier. The exceptions are a physician or nonphysician practitioner, or a PT or OT, furnishing items to their own patients, and a DMEPOS supplier co-located with and owned by an enrolled provider that operates as a separate unit.
• Standard 30: open to the public at least 30 hours a week, except physician and PT or OT locations furnishing to their own patients, and suppliers working with custom-made orthotics and prosthetics.

Our site visit checklist turns these into a walk-through.

How does the supplier have to treat beneficiaries?

• Standard 4: fill orders from your own inventory or by contracting with other companies, with contracts available on request, and never contract with an entity excluded from Medicare, state health programs or federal procurement.
• Standard 5: tell beneficiaries they may rent or purchase inexpensive or routinely purchased equipment, and about the purchase option for capped rental equipment, with documentation on request.
• Standard 6: honor all warranties under state law and never charge the beneficiary or Medicare for warranty repair or replacement.
• Standard 11: no telephone contact with a beneficiary about supplying a Medicare item unless the person gave written permission, the call coordinates delivery of an item already furnished, or, for a different item, you furnished at least one covered item in the previous 15 months.
• Standard 12: you are responsible for delivery and must keep proof of delivery, and must document that the beneficiary received instructions on safe and effective use.
• Standard 13: answer questions and respond to complaints, and document those contacts.
• Standard 14: maintain, repair or replace at no charge the items you rent, directly or through a service contract.
• Standard 15: accept returns of substandard or unsuitable items.
• Standard 16: disclose the supplier standards to every beneficiary you supply.
• Standard 19: have a complaint resolution protocol and keep written complaints, correspondence and notes of actions taken, at the physical facility.
• Standard 20: for every complaint, written or oral, record the beneficiary's name, address, telephone number and health insurance claim number, a summary, the date received, who received it and what was done, or who decided not to investigate and why.

The DMEPOS Quality Standards that accrediting organizations survey against add timelines on top: acknowledge a complaint within 5 calendar days and give the beneficiary written results of the investigation within 14 calendar days.

Which standards deal with insurance, the bond and the supplier number?

• Standard 10: comprehensive liability insurance of at least $300,000 covering the place of business and all customers and employees, plus product liability and completed operations coverage if you manufacture items. "Failure to maintain required insurance at all times results in revocation of the supplier's billing privileges retroactive to the date the insurance lapsed." An authorized official must sign the policy. See liability insurance requirements.
• Standard 18: never convey or reassign a supplier number.
• Standard 26: meet the surety bond requirements of 424.57(d). See the DMEPOS surety bond.
• Standard 27: obtain oxygen from a state-licensed oxygen supplier, in states that license oxygen.
• Standard 28: keep the ordering and referring documentation required by 424.516(f), which runs 7 years from the date of service.

What do the accreditation standards require after 2026?

• Standard 22: all suppliers and all their locations, owned or subcontracted, must meet the DMEPOS quality standards and be separately accredited to enroll and bill. The accreditation must name the specific products and services, and an accredited supplier can still be denied or revoked if CMS finds it non-compliant with the quality standards.
• Standard 23: notify your accrediting organization when a new location opens. The CY2026 home health final rule (90 FR 55342) removed the old allowance that let a new location operate for 90 days before its survey; CMS's MLN905710 now says new locations "must be surveyed before being accredited."
• Standard 24: "All accredited DMEPOS suppliers must be surveyed and reaccredited at least once every 12 months." Before January 1, 2026 the cycle was three years. See annual reaccreditation.
• Standard 25: disclose all products and services at enrollment, and notify the accrediting body of any new product line so it can be surveyed and accredited.

Are there other payment rules beside the 30 standards?

Yes, in the same section. Paragraph (b) requires a separate enrollment for each physical location other than warehouses and repair facilities and pays only for items furnished on or after the date CMS issued the supplier number. Paragraph (f) bars payment to a CPAP supplier that, directly or through an affiliate, provided the sleep test used for the diagnosis, unless it was an attended facility-based polysomnogram. Paragraph (g) requires revalidation every three years, and paragraph (h) points to the 36-month majority ownership rule in 424.551 (see the 36-month rule).

When does a missed standard become a revocation?

Most often at a site visit or after a complaint. The revocation rules set the effective date for a supplier standard violation as "the date on which the non-compliance began" (424.535(g)), and the insurance and bond rules make lapses retroactive. That is why the standards are worth treating as a running checklist rather than a box ticked at enrollment. Our post on why billing privileges get revoked covers what follows.

How do we check a supplier against the standards?

The $149 DMEPOS Readiness Review walks your location, phone setup, hours, insurance certificate, product list and complaint process against all 30 standards before you apply, and the fee is credited toward a package. Annual Survey Readiness, $1,200 per year, repeats the check before each accreditation resurvey.