Benefits of DMEPOS
Reliable and cost-effective, these are the top two ways to describe NABP’s Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) accreditation for pharmacies. With more than 100 years of experience in pharmacy, NABP understands the complexities of modern pharmacy practice and is committed to ensuring that Medicare beneficiaries receive the appropriate products, services, and patient care associated with DMEPOS products.
The Centers for Medicare & Medicaid Services (CMS) mandates that certain suppliers of DMEPOS must attain accreditation to obtain or maintain Medicare billing privileges. NABP DMEPOS accreditation ensures that a pharmacy meets rigorous program standards.
NABP’s DMEPOS accreditation program is best suited to pharmacies that distribute DMEPOS products and services that fall within NABP’s scope of accreditation.
What is the process to become accredited?
After a pharmacy submits a DMEPOS application, NABP will:
- Verify the pharmacy’s licensure;
- Assess the pharmacy’s professional policies and procedures; and
- Conduct an unannounced on-site survey of the pharmacy.
Visit the Apply page for a detailed breakdown of the accreditation process.
Is NABP DMEPOS Accreditation Right for Your Pharmacy?
NABP’s DMEPOS accreditation program is a perfect fit for those pharmacies that distribute DMEPOS products that fall within NABP’s scope of accreditation.
DMEPOS accreditation is required for suppliers who wish to obtain or maintain Medicare Part B billing privileges for products and services subject to Centers for Medicare & Medicaid Services (CMS) quality standards.
For more information on Medicare enrollment or Part B billing privileges, see the National Supplier Clearinghouse.
Drugs Associated with Durable Medical Equipment
Drugs used with durable medical equipment (for example, inhalation drugs, drugs infused with a DME pump) are not subject to CMS quality standards. If a pharmacy supplies drugs used with durable medical equipment, but does not supply items subject to CMS quality standards, it will not need DMEPOS accreditation. Medicare Part B drugs identified in section 1861(s) of the Social Security Act (eg, immunosuppressive drugs, oral anti-emetic drugs) are not subject to quality standards.
However, home dialysis supplies, nutrients furnished using enteral or parenteral devices, blood products, and transfusion medicine are subject to quality standards. Suppliers of these products will need to attain DMEPOS accreditation if they wish to maintain Medicare billing privileges.
Items Subject to Quality Standards
- All DME described in section 1834(a)(13) of the Social Security Act and paid in accordance with section 1834(a) but not including drugs or implantable items furnished by an outpatient hospital department that are not paid for in accordance with section 1861(n) of the Act. The term DME is defined in section 1861(n) of the Act.
- Prosthetic devices, orthotics, and prosthetics described in section 1834(h)(4).Prosthetic devices except it does not include parenteral and enteral (however, parenteral and enteral are subject to the quality standards because they are referenced in section 1842(s)(2) as indicated below) and does not include implantable items paid for in an outpatient hospital department.
- Orthotics (braces), prosthetics (artificial limbs), and diabetic shoes but does not include intraocular lenses or medical supplies (eg, catheters, catheter suppliers, ostomy bags, and supplies) furnished by a Home Health Agency (HHA). (Note: these items are bundled into the HHA prospective payment system.)
- Additional items referenced in section 1842(s)(2):
a. Medical supplies
b. Home dialysis supplies and equipment
c. No items listed
d. Parenteral and enteral
e. Electromyogram devices (currently not covered)
f. Salivation devices (currently not covered)
g. Blood products
h. Transfusion Medicine
DMEPOS Products Approved for Accreditation by NABP
NABP is approved by CMS to accredit the following product categories from the Medicare Enrollment Application (or CMS 855S Form):
- Blood Glucose Monitors and/or Supplies (non-mail order)
- Blood Glucose Monitors and/or Supplies (mail order)
- Breast Prostheses and/or Accessories
- Canes and/or Crutches
- Continuous Positive Airway Pressure (CPAP) Devices and/or Supplies
- Diabetic Shoes/Inserts
- Diabetic Shoes/Inserts-Custom
- Enteral Nutrients
- Enteral Equipment and/or Supplies
- External Infusion Pumps and/or Supplies
- Heat & Cold Applications
- Insulin Infusion Pumps and/or Supplies
- Nebulizer Equipment and/or Supplies
- Orthoses: Off-The-Shelf
- Ostomy Supplies
- Parenteral Nutrients
- Parenteral Equipment and/or Supplies
- Respiratory Assist Devices
- Seat Lift Mechanisms
- Surgical Dressings
- Urological Supplies
Please contact the National Supplier Clearinghouse or your DME Medicare Administrative Contractor (DME-MAC) for information on specific items each category contains or other billing questions.
The DMEPOS competitive bidding program is designed to help lower out-of-pocket costs and improve access to certain high-quality DMEPOS products for Medicare beneficiaries. The competitive bidding program was mandated through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 through a statute that requires Medicare to replace its fee schedule with a competitive bid process.
The competitive bid payment amounts are determined by using bids submitted by DMEPOS suppliers. The intent of the competitive bidding program is to set more appropriate payment amounts for DMEPOS items, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program.
To participate in the Medicare DMEPOS competitive bidding program, suppliers must be accredited by a CMS-approved accreditation organization, meet licensing requirements, and, if applicable, become bonded; additional requirements may apply.
Learn More About Competitive Bidding
Information about competitive bidding changes frequently. For up-to-date information, including the bidding timeline and rules, user guides, frequently asked questions, and policy fact sheets and checklists, please visit the Competitive Bidding Implementation Contractor (CBIC) website.