The durable medical equipment (DME) market in the United States continues to grow, making it an excellent opportunity to become a DME provider. According to a market analysis report, in 2021, the DME market was valued at $56.3 billion, with an anticipated growth of 5.7% until 2030! This upward trend is due to the rising elderly population that has become increasingly vulnerable to chronic diseases.
In order to legally operate a DME business, you’ll need to meet several prerequisites from your state and the Center for Medicare & Medicaid Services (CMS). Then once you become an accredited provider, you’ll need to comply with industry regulations when submitting claims.
Continue reading to learn what is required to become a DME provider in the United States.
6 Steps on How to Become a DME Provider
With the anticipated industry growth, becoming a DME provider can be a profitable business. However, it’s important to note that there are several steps you’ll need to complete to operate your business.
Make Your Business Legal with the State and Federal Government
Registering with the state typically takes 1-2 weeks. Requesting a federal tax ID typically takes a few weeks.
Request a National Providers Identification (NPI)
An NPI is the ten-digit identification number that you’ll use on all business transactions. All providers need one since you’ll use it for CMS and commercial health plan insurances. This number identifies your practice with CMS.
Complete the DME Accreditation Process
In order to become a provider, you’ll need to work with one of the CMS-approved accreditation companies to learn the necessary rules and regulations. Then the approved company will review and ensure you meet all the required standards. The approval process can take several months to complete.
Meet the Code of Federal Regulations (CFR)
The CFR is a set of 42 codes. CMS requires all accredited providers to meet these codes to obtain their Medicare billing privileges.
Complete Your Medicare Enrollment Application
While completing your Medicare enrollment application, you’ll work with a Medicare Administrative Contractor (MAC) to help ensure a smooth process (you’ll work with the representative assigned to your region of practice).
Acquire a DME Security Bond
During the enrollment process, you’ll need to acquire a $50,000 security bond (for each NPI you have) to meet CMS’ bonding requirements. During this, you’ll need to pay a bond premium, typically between 1%-5% (depending on your finances). For instance, if your bond is $50,000 you would need to pay between $500-$2,500.
Maintain Your Billing Accuracy with Medbill
As you begin to place orders and submit claims, remember that the DME industry frequently adjusts policies and regulations regarding DME. You’ll want to ensure that you stay current on all industry changes so your claims are accepted and paid on time – that’s where Medbill can help you. As a DME billing expert, our team works daily with providers to ensure their billing accuracy, audit readiness, and more.