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Short answer: the DMEPOS supplier standards are the 30 conditions in 42 CFR 424.57(c) that a Medicare supplier of durable medical equipment, prosthetics, orthotics and supplies certifies on its enrollment application that it meets and will keep meeting. Failing them, or the payment conditions in 424.57(b), lets CMS revoke billing privileges. This page groups the 30 standards by what the supplier must do, with the standard numbers, and explains the surety bond, accreditation and revocation rules around them. It is general regulatory information, not legal or individual medical advice.
Definition and scope
Under 42 CFR 424.57(a), a DMEPOS supplier is an entity or individual, including a physician or a Part A provider, that sells or rents Part B covered items to Medicare beneficiaries and meets the standards in paragraphs (c) and (d) of the section. DMEPOS stands for durable medical equipment, prosthetics, orthotics and supplies. Paragraph (c) is the list of 30 application certification standards; paragraph (d) is the surety bond requirement, which standard 26 incorporates.
What is DME in healthcare?
DME is durable medical equipment, the first letter group in DMEPOS. The regulation defines the covered scope as medical equipment and supplies as defined in section 1834(j)(5) of the Social Security Act and does not itself list products. For examples of items and how they are coded, see the CASRAI guide to the durable medical equipment list, and the guide to the DME MACs that process DMEPOS claims.
How the standards work in practice
A supplier signs the certification on the CMS-855S enrollment application, and the form’s own supplier-standards page states that the standards in their entirety, including the surety bond provisions, are listed in 42 CFR 424.57. The payment conditions in paragraph (b) sit beside the standards: a completed application, an item furnished on or after the date CMS issued the supplier number (one number per location), no revocation or exclusion during that period, and all information CMS needs to process the claim. Separate physical locations must be enrolled, except locations used solely as warehouses or repair facilities.
The 30 standards grouped by what they require
| Area | Standard (424.57(c)) | What the regulation requires |
|---|---|---|
| Application integrity | 1, 2, 3, 18, 21 | Comply with federal and state requirements (including state licensure); no false statements; report application changes within 30 days; application signed by someone whose signature binds the supplier; never convey or reassign a supplier number; give CMS requested information. |
| Facility and phone | 7, 8, 9 | A practice location of at least 200 square feet (with an exception for certain orthotic and prosthetic personnel), accessible to the public and CMS, staffed during posted hours, with a permanent visible sign and space for business records; permits on-site inspection; a primary business telephone at the site that is not a cell phone, pager or answering service alone. |
| Hours and co-location | 29, 30 | Open to the public at least 30 hours per week; may not share a practice location with another Medicare supplier or provider. Each has listed exceptions, for example a physician or therapist furnishing items to their own patients. |
| Insurance and bond | 10, 26 | Comprehensive liability insurance of at least $300,000 covering the place of business, customers and employees (lapse results in revocation retroactive to the lapse date); the surety bond in paragraph (d). |
| Sourcing and orders | 4, 27, 28 | Fill, fabricate or fit items from own inventory or through contracts, and not contract with an excluded entity; obtain oxygen from a state-licensed oxygen supplier where the state requires licensure; keep ordering and referring documentation under 424.516(f). |
| Beneficiary protections | 5, 6, 11, 12, 13, 14, 15, 16, 17 | Advise on rent-or-purchase options; honor warranties; limits on telephone contact; responsibility for delivery with proof of delivery and use instructions; answer questions and complaints; repair or replace rented items at no charge; accept returns of substandard items; disclose the standards to each beneficiary; comply with the 420.206 disclosure provisions. |
| Complaint records | 19, 20 | A complaint resolution protocol, with written complaints, correspondence and actions kept at the physical facility and available to CMS, plus specified details on every written and oral complaint. |
| Accreditation | 22, 23, 24, 25 | Meet the DMEPOS quality standards and be separately accredited, location by location and for specific products; notify the accrediting organization of a new location; be surveyed and reaccredited at least every 12 months; disclose all product lines and re-survey when adding one. |
The table summarizes the text of 42 CFR 424.57(c) as published in the eCFR (current to 2026-10-28); the regulation itself is the controlling wording.
Surety bond and insurance figures
- Base bond: $50,000 from an authorized surety, continuous in type, submitted with the CMS-855S application. A new practice location needs a new bond or a rider showing an additional base bond.
- Elevated bond: where the CMS contractor requires it, $50,000 per occurrence of an adverse legal action in the 10 years before enrollment, revalidation or re-enrollment.
- Surety payment: within 30 days of CMS written notice with sufficient evidence of unpaid claims, civil money penalties or assessments.
- Cancellation: written notice at least 30 days before the effective date; cancelling without a replacement bond is grounds for revocation. A lapse reported to CMS revokes billing privileges, and Medicare does not pay for items furnished during the gap.
- Exceptions: certain government-operated suppliers with a comparable state bond, state-licensed orthotic and prosthetic personnel in qualifying solo practices, physicians and nonphysician practitioners furnishing items only to their own patients, and qualifying physical or occupational therapists in private practice.
- Liability insurance: at least $300,000, separate from the bond.
Accreditation under standards 22 to 25
Accreditation is a standard in its own right, not a separate program: an accredited supplier can be denied enrollment or revoked if CMS finds it noncompliant with the DMEPOS quality standards. Accreditation organizations and survey expectations are covered in the CASRAI guide to DMEPOS accreditation.
What happens when a supplier does not meet the standards
Under 424.57(e), CMS revokes billing privileges if a supplier is found not to meet the conditions or standards in paragraphs (b) and (c); the revocation effective date generally follows 42 CFR 424.535. CMS or a contractor may also reopen claims paid on or after the date of a final adverse action to establish an overpayment. Bond failures have their own rule: if a bond is not obtained, filed on time or maintained, revocation is effective the date the bond lapsed and payments for items furnished from that date must be repaid. Suppliers must also revalidate every 3 years under 424.57(g).
Common misunderstandings
- Accreditation is not the whole standard set. It covers standards 22 to 25; the other 26 apply separately.
- The bond is not insurance for the supplier. It guarantees payment to CMS of unpaid claims, penalties or assessments; the liability insurance requirement is standard 10.
- The 200 square feet and 30-hour rules are not universal. Both carry listed exceptions, such as custom orthotic and prosthetic personnel and physicians or therapists furnishing items to their own patients.
- Coding rules are a different layer. Claim-level documentation, such as the KX modifier, comes from coverage policy; see the guide to HCPCS modifier KX.
Frequently asked questions
What is DME in healthcare?
Durable medical equipment: the regulation treats it as part of DMEPOS and defines covered items by reference to section 1834(j)(5) of the Social Security Act. See the durable medical equipment list for examples.
How many DMEPOS supplier standards are there?
Thirty, numbered (c)(1) through (c)(30) in 42 CFR 424.57, plus the surety bond requirements in paragraph (d).
How much liability insurance and surety bond does a supplier need?
Standard 10 requires comprehensive liability insurance of at least $300,000. The base surety bond is $50,000, with an elevated amount of $50,000 per adverse legal action in the prior 10 years where the contractor requires it.
Must a supplier be accredited?
Yes. Standard 22 requires suppliers and all their locations to meet the DMEPOS quality standards and be separately accredited, for the specific products and services billed, and standard 24 requires survey and reaccreditation at least once every 12 months.
Sources
- 42 CFR 424.57, Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier billing privileges, eCFR (current to 2026-10-28): https://www.ecfr.gov/current/title-42/section-424.57. Date checked: 2026-10-30.
- CMS-855S, Medicare Enrollment Application for DMEPOS Suppliers, section on DMEPOS supplier standards for Medicare enrollment (edition showing an expiration date of 12/31/2025): https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms855s.pdf. Date checked: 2026-10-30.
