Medicare billing privileges start with the bond on file.

A DMEPOS bond is the surety bond the Centers for Medicare and Medicaid Services requires from suppliers of durable medical equipment, prosthetics, orthotics, and supplies as a condition of Medicare enrollment. Without it, your enrollment application will not be approved and existing billing privileges can be revoked.

The bond protects the Medicare Trust Fund. If CMS pays claims that turn out to be unsubstantiated, fraudulent, or otherwise improper, it can recover against the bond, along with associated penalties and assessments. The surety pays and then seeks reimbursement from the supplier, so the bond is a guarantee of your billing conduct rather than insurance that absorbs the loss for you.

The requirement is generally applied per National Provider Identifier, so a supplier operating multiple enrolled locations under separate NPIs will require a bond for each one. Certain government-operated suppliers and some state-licensed practitioners are treated differently under the regulations, so it is worth confirming your status with your Medicare Administrative Contractor before you assume you are exempt.