A DMEPOS supplier enrolls with Medicare on the CMS-855S, through one of two National Provider Enrollment contractors, NPEAST or NPWEST. Every location enrolls separately, meets 30 supplier standards and carries its own bond. Most delays come from doing the steps out of order.
The order CMS requires
- Step 1
State licenses
Every license your states require for the items you furnish (42 CFR 424.57(c)(1)). The accrediting organization checks them at application.
- Step 2
Location, policies and insurance
A site that meets the supplier standards: at least 200 square feet, posted hours, a permanent sign, open at least 30 hours a week (with exceptions), and $300,000 of liability insurance.
- Step 3
Accreditation
Non-exempt suppliers must be accredited before they apply. The enrollment contractors will not process an application from a supplier that is not accredited or exempt.
- Step 4
Surety bond
$50,000 per NPI, plus $50,000 for each added location and for each adverse legal action in the prior 10 years.
- Step 5
CMS-855S and the fee
The application and the $750 fee for 2026, signed by the supplier’s authorized official.
- Step 6
Screening and site visit
New suppliers are screened as high risk: an on-site visit and fingerprints for every owner of 5% or more.
- Step 7
Billing number
Each location gets its own supplier number once the enrollment contractor approves it.
What changed on January 1, 2026
- Annual reaccreditation
- Suppliers are surveyed and reaccredited at least once every 12 months (424.57(c)(24)). Existing suppliers move to the annual cycle when their current term ends.
- No temporary accreditation for new locations
- The accrediting organization surveys a new location before accrediting it.
- The 36-month ownership rule
- A majority ownership change within 36 months of enrollment, or of the last majority change, means the buyer enrolls as a new supplier with new accreditation (424.551).
Licenses for Round 2028 competitive bidding
Round 2028 covers CGMs and insulin pumps, hydrophilic catheters, ostomy and urological supplies and off-the-shelf braces, with one nationwide remote item delivery area. A bidder must hold every license required in each state where it would furnish those items, current in PECOS by the close of the bid window. Contracts start no later than January 1, 2028. State license requirements.
Want us to prepare it?
The Medicare enrollment package is $1,295 for the first location and $595 for each added location; accreditation readiness is $2,495. CMS, accreditation, bond and state fees are paid by you directly. See every price.
Questions
- Can we enroll first and get accredited later?
- No. Unless you are exempt, you must be accredited before you submit the 855S, and the enrollment contractors will not process an application without it.
- Who signs the 855S?
- Your authorized official, someone with ownership or control who can bind the company. A delegated official must be an owner or a W-2 managing employee. We prepare the application and, once your official approves us as a PECOS surrogate, enter and submit it; your official signs the certification.
- Do you sell the surety bond?
- No. We gather the documents your own licensed surety agent needs and track the bond, but we do not sell bonds or take commissions on them.
- What do Round 2028 bidders need?
- Every state license required for the items they would furnish, current in PECOS by the close of the bid window. CMS set the bid window to open January 5, 2027, with registration from December 1, 2026. Round 2028 includes one nationwide remote item delivery area.
Sources: 42 CFR 424.57, 424.518, 424.551, 90 FR 55342, CBIC. Not affiliated with CMS, any enrollment contractor, DME MAC, accrediting organization or state agency.