Written and maintained by CASRAI Editorial Board
Last updated
Short answer: A DME license is a state-issued license, and it is only one of several separate gates a durable medical equipment supplier passes. Under Medicare’s supplier rule, if a state requires licensure for an item or service, the supplier must hold that license. Medicare enrollment, a $50,000 surety bond and accreditation are different requirements issued by different bodies. This page is general information, not legal or medical advice.
What is a DME license (and what it is not)
There is no single national “DME license.” The rule that matters for Medicare billing is 42 CFR 424.57(c)(1)(ii): if a State requires licensure to furnish certain items or services, a DMEPOS supplier must be licensed to provide the item or service, and may contract with a licensed individual or other entity to provide the licensed services unless State law expressly prohibits it. Whether a license is needed therefore depends on the state and on the products or services furnished. A CMS enrollment presentation says the same: licensure “depends on state and products/services you plan to furnish.”
A license is not Medicare enrollment, not accreditation and not a bond. Each is checked separately, which is why a supplier can hold one and still lack another.
Do I need a license to sell DME, or medical supplies in general?
If your state requires licensure for the items or services you furnish, and you want to bill Medicare, yes: the federal rule makes that state license a condition. The rule does not say which states require one or for which items; that is set by each state. Check the state’s own requirement and the Medicare contractors’ licensure database described below rather than relying on a general summary.
How to get a DME license: the sequence of gates
The state license comes from the state. After it, Medicare billing adds several federal steps. The table compares the gates and cites the rule or agency page behind each.
| Gate | Who sets or checks it | What the source says |
|---|---|---|
| State license | The state, where it requires one | 42 CFR 424.57(c)(1)(ii): a supplier must be licensed for items or services the state licenses. |
| Medicare enrollment | CMS enrollment contractors (the National Provider Enrollment contractors) | Noridian: two contractors process all DMEPOS enrollment applications based on the physical location of the supplier’s office; the contractors issue or revoke Medicare supplier billing privileges. |
| Surety bond | Submitted to the CMS contractor with the application | 42 CFR 424.57(d)(2)(i): a surety bond from an authorized surety of $50,000 (an elevated amount may be required in some cases). |
| Accreditation | A CMS-approved accrediting organization | 42 CFR 424.57(c)(22): suppliers must meet the DMEPOS quality standards and be separately accredited to enroll in and bill Medicare, for the specific products and services listed. |
The Medicare application asks for copies of all applicable federal and state licenses and certifications.
How to apply for a DME license
The license application itself is a state process, and this page does not describe individual states’ forms or fees. The Medicare side is the enrollment application (Form CMS-855S), which the CMS slides say can be filed online or on paper; the online route is described by Noridian as the quickest. For the supplier standards behind enrollment, see DMEPOS supplier standards under 42 CFR 424.57. Enrollment also relies on an NPI; see how to apply for an NPI number and what PECOS is.
How to get DME certified
“Certified” is not one credential. For Medicare billing the relevant step is accreditation by an approved organization; the CMS slides list ACHC, BOC Accreditation International, CHAP and HQAA among them. See DMEPOS accreditation for who needs it and who is exempt.
How long does it take to get a DME license?
State timelines are set by each state and are not covered here. For the Medicare enrollment step, the CMS slide cites processing targets of about 15 days for online applications and about 30 days for paper, marked on the slide as targets rather than promises.
DME license cost
State license fees are set by each state and are not stated here. The federal figure that is fixed in the regulation is the $50,000 surety bond amount (not the premium paid for it).
After you hold the license: maintenance
The CMS slides say to report any change of information within 30 days, including a change of insurance, surety bond or licensure, and that failure to report within 30 days may result in revocation action. They also state revalidation is every 3 years. The Medicare contractors’ DME licensure database, which the slides say is maintained by the NPE West contractor and updated quarterly, is where state licensure expectations are looked up. An American Podiatric Medical Association release of 25 June 2025 reported that the eastern contractor was building its own licensure database, with suppliers serving states on both sides checking both; check the current contractor sites for what exists today.
Where it matters for labs, clinics and buyers: what to ask a supplier to show
For anyone sourcing durable medical equipment, the gates above give a documented checklist of what a supplier should be able to show: the state license where one applies, Medicare enrollment, the surety bond, and accreditation covering the specific products. See Medicare-approved durable medical equipment suppliers and medical equipment suppliers and what to verify for how to verify each. State Medicaid programs may add their own rules; see Medicaid DME.
Common misunderstandings
- “A DME license lets me bill Medicare.” No. Billing privileges come from Medicare enrollment, which also requires the bond and accreditation.
- “Accreditation replaces the license.” No. The regulation lists state licensure and accreditation as separate requirements.
- “One license covers every state.” The rule ties the license requirement to what a state requires; it does not create a national license.
FAQ
What is a DME license?
A state license to furnish durable medical equipment items or services, in states that require one. Medicare’s supplier rule makes holding it a condition when a state requires it.
Do you have to have a license to sell medical supplies?
It depends on the state and the items or services. For Medicare billing of DMEPOS, the supplier must hold any license the state requires; this page does not list which states or items.
How to get DME certified?
Medicare calls it accreditation, issued by an approved accrediting organization, in addition to the license and enrollment.
How long does it take to get a DME license?
Set by each state. The CMS slide cites roughly 15 days (online) or 30 days (paper) as targets for the Medicare enrollment application.
What does the DME business need besides a license?
Medicare enrollment (CMS-855S), a $50,000 surety bond, accreditation and ongoing change reporting within 30 days, as described above.
Sources
- 42 CFR 424.57, Special payment rules for items furnished by DMEPOS suppliers: law.cornell.edu/cfr/text/42/424.57 (checked 2026-11-01).
- CMS, DME Enrollment, National Provider Enrollment Conference, 28 to 29 August 2024: cms.gov DME enrollment slides (checked 2026-11-01).
- Noridian JD DME, Enrollment: med.noridianmedicare.com/web/jddme/topics/enrollment (checked 2026-11-01).
- American Podiatric Medical Association, news release, 25 June 2025: Licensure requirements for DMEPOS providers (checked 2026-11-01).
