If you’re a chiropractor, physical therapy clinic, or healthcare provider looking to distribute durable medical equipment (DME) like back braces, knee supports, or CPAP machines you’ve likely encountered two important terms: DMEPOS Accreditation and a DME License.
They may sound alike, but each one has a different and important job in compliance. Mixing them up could slow down your Medicare approval, deny claims, or even stop your DME operations.
| Credential | Purpose |
|---|---|
| DME License | Legal permission (state & federal) to sell/bill DME |
| DMEPOS Accreditation | Certification of compliance with Medicare standards |
You need both to legally dropship DME products, bill Medicare, and pass CMS audits.
A DME License: What Is It?
Your clinic or business can lawfully sell, deliver, or bill for DME products with a DME license, which is a state-level and occasionally federal-level authorization.
Important Information:
Published by: Departments of Health, State Boards of Pharmacy, or Licensing Divisions
Needed for: Billing and selling devices such as CPAPs, walkers, braces, etc.
NPI (National Provider Identifier), Tax ID, and business registration are also necessary.
DME suppliers, including those shipping remotely, are required to obtain specific DME licenses in states such as Florida, Texas, New York, and California.
Without a DME License, You Cannot:
• Legally, bill Medicare or Medicaid for dropshipped goods
• Collaborate with PDAC-approved suppliers
• Become listed in PECOS or DMEPOS-accredited
• Observe the NSC inspection guidelines
What Is DMEPOS Accreditation?
DMEPOS stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.
Accreditation is a mandatory CMS certification proving you follow best practices in:
• Patient care
• Claims processing
• Complaint handling
• Equipment delivery and quality control
Accreditation Bodies Include:
• ACHC – Accreditation Commission for Health Care
• BOC – Board of Certification/Accreditation
• The Compliance Team (TCT)
• HQAA, CHAP, DNV
Each follows CMS’s DMEPOS Supplier Standards, and failure to comply may lead to:
• Suspension from Medicare
• Fines or recoupments
• Public delisting from PECOS
DME License vs. DMEPOS Accreditation: Key Differences
What Equipment Falls Under Each?
| Type of Equipment | Needs License? | Needs Accreditation? |
|---|---|---|
| Orthopedic Braces (L-codes) | ✅ | ✅ |
| CPAP/BiPAP Machines | ✅ | ✅ |
| Walkers/Crutches | ✅ | ✅ |
| Off-the-shelf orthotics | ✅ | ✅ |
| Prosthetics/Custom devices | ✅ | ✅ |
If you sell, rent, or distribute durable medical equipment to patients — even through B2B channels you likely need a DME license.
This includes:
• B2B DME suppliers and wholesalers
• Dropshippers fulfilling orders for clinics or providers
• Companies billing Medicare or other iznsurance payers
Even if you never see the patient face-to-face, your business may still be regulated if the products you supply are eligible for coverage. Licensing is most often required for Medicare enrollment, and it helps to ensure compliance with state and federal regulations.
State-Specific Licensing Requirements
| State | Licensing Agency | DME License Required? | Notes |
|---|---|---|---|
| Florida | Dept. of Health + AHCA | ✅ | Separate licenses for home medical equipment (HME) |
| Texas | Texas DSHS | ✅ | Requires fingerprinting + in-person inspection |
| California | CA Board of Pharmacy | ✅ | Wholesaler + retailer licenses needed |
| New York | Office of Professions | ✅ | May require corporate registration |
| Illinois | Dept. of Financial Regulation | ✅ | City-level permits sometimes needed |
Always check both state and city requirements. Many remote states (like GA or AZ) still require in-state compliance if you ship to residents.
Medicare Application & CMS Requirements
Here’s what you’ll need:
- Form CMS-855S (Supplier Enrollment)
- DMEPOS Accreditation Proof
- $50,000 Surety Bond
- NPI & EIN
- Business Insurance (Liability + property)
- PECOS Registration
- Background Check + Fingerprints
- CMS Fee (~$688 as of 2025)
Which Comes First: License or Accreditation?
To avoid rejections and delays, follow this order:
- Register your business (LLC or Corp)
- Obtain an NPI (National Provider Identifier)
- Apply for DMEPOS Accreditation
- Secure a $50,000 Surety Bond
- Submit CMS-855S with supporting docs
- Apply for your State DME License
- Complete site inspection
- Register in PECOS and NSC
Renewals & Compliance Checks
Accreditation: Renew every 3 years. Keep logs of complaints, patient education, and delivery records.
License: Varies by state. Some annual, some biannual. Watch expiration dates.
Bond: Must remain active or CMS may suspend payments.
How Ava Medical Supply Helps You Stay Compliant
aAt Ava Medical Supply, we only partner with providers who are licensed, accredited, and Medicare-compliant.
We provide:
• Access to PDAC-approved products with L-codes
• Compliant documentation templates
• Medicare-ready shipping and fulfillment
• No stocking or warehouse headaches
• Dedicated support for audits, forms, and billing help
Real-World Example
One clinic in Texas delayed their DMEPOS approval by 90 days because they forgot to submit their surety bond. That delay cost them over $15,000 in denied claims. Avoid such costly mistakes by following the exact CMS checklist and working with experienced suppliers like Ava.
FAQs
No. Most states require both. CMS won’t approve Form 855S without accreditation.
Between $1,000–$7,000 depending on the accreditor, scope, and services offered.
It’s a $50K security bond CMS requires to protect against overbilling or fraud.
No. Each clinic or facility must be individually accredited and licensed.
Key Takeaways
DME license = Legal authorization to bill and sell DME.
DMEPOS accreditation = Certification that you meet CMS standards.
You need both to bill Medicare, dropship legally, or pass audits
Always check state-specific licensing rules.
📞 Need Help Getting Licensed or Accredited?
We’ve helped hundreds of clinics get accredited, pass audits, and launch successful DME dropshipping businesses. Get Started with Ava Medical Supply.
Expert guidance. No warehouse needed. Total compliance.
