After multiple rounds, contract expirations, and years of pauses and adjustments, it’s been unclear whether (or when) Medicare’s DMEPOS Competitive Bidding Program would return.
But now, we have more clarity—and more importantly, a timeline.
CMS has formally outlined plans to restart competitive bidding, with a new structure, narrower scope, and a longer runway before pricing takes effect. While most providers won’t feel immediate payment changes, the decisions CMS is making now will shape reimbursement, supplier participation, and compliance requirements for years to come. Here’s how to prepare without overreacting.
Competitive Bidding is Restarting
As of now (January 2026), competitive bidding is not actively driving Medicare payment rates for most DME categories. Contracts from the last round expired at the end of 2021, and CMS has been operating under temporary payment rules during the gap period.
That gap is now closing.
CMS has confirmed that it is restarting the DMEPOS Competitive Bidding Program, with bidding activity expected to resume over the next two years and new pricing scheduled to take effect no earlier than January 1, 2028.
In other words, there is no immediate disruption to most providers today, but CMS is clearly laying the groundwork for the next round
This means the window to prepare strategically is open—and likely shorter than it appears.
The Next Round Will Look Very Different
One of the most important things to understand is that this is not a return to the broad, category-wide competitive bidding of the past.
CMS has stated that the upcoming round will be more targeted, focusing primarily on Remote Item Delivery (RID) product categories rather than traditional in-person DME services.
Categories expected to be included:
- Continuous Glucose Monitors (CGMs)
- Insulin infusion pumps
- Urological supplies
- Ostomy supplies
- Hydrophilic urinary catheters
- Off-the-shelf back, knee, ankle, wrist, and upper-extremity braces
Notably, oxygen, CPAP, mobility products, and many core HME categories are not included at this stage.
For suppliers who specialize in consumables, mail-order supplies, or nationwide fulfillment models, this shift matters. CMS is prioritizing categories where products can be shipped anywhere in the US, and supplier differentiation is less dependent on in-person clinical services.
Nationwide Contracts and Remote Delivery
Another major structural change: all included product categories will be bid on a nationwide basis.
This means:
- No more regional competitive bidding areas (CBAs)
- Winning suppliers must be able to serve beneficiaries across the entire country
- Logistics, fulfillment speed, inventory accuracy, and documentation will matter more than ever
For smaller or regionally focused suppliers, this raises real questions: Is nationwide fulfillment operationally feasible? Are margins sustainable under national pricing?
Competitive bidding may no longer be “local competition.” It’s shaping up to be a national operational test.
This shifts competitive bidding from a pricing exercise to an operational one, where scale, systems, and execution discipline matter as much as bid strategy.
Industry Concerns Haven’t Gone Away
Provider groups, manufacturers, and patient advocates continue to raise concerns—especially around:
- Patient access and product choice
- Pressure on smaller or specialized suppliers
- Operational strain caused by pricing compression
While CMS has acknowledged these concerns, it has not slowed the restart process. Instead, it appears focused on refining the model rather than abandoning it.
For DME owners, this reinforces a familiar reality: No matter how you feel about competitive bidding, your business needs to operate successfully within the program.
Key Changes to How Competitive Bidding Works
Here’s the headline: CMS is reviving the competitive bidding program and modifying how it functions. Several changes are worth close attention.
1. New Payment Methodology
Instead of setting reimbursement based on the maximum winning bid, CMS plans to calculate single payment amounts using the 75th percentile of winning bids. The intent is to reduce extreme underbidding while still controlling costs.
Whether this actually stabilizes pricing remains to be seen, but it signals that CMS is responding (at least partially) to criticism of earlier rounds.
2. Annual Accreditation
CMS has proposed shifting from a three-year accreditation cycle to annual reaccreditation for competitive bidding suppliers.
For owners, this means more frequent documentation reviews, less room for operational slippage, and higher ongoing compliance costs
3. Centralized Bidding Systems
CMS is consolidating supplier enrollment and bidding tools into a single platform. While intended to reduce administrative friction, it also means data accuracy across systems will be more visible.
Discrepancies between enrollment records, billing data, and bid submissions could quickly become disqualifying issues.
What DMEs Should Be Doing Now
Even though contracts won’t take effect for several years, waiting is risky. The strongest operators are already using this time to:
- Audit billing and documentation workflows. Errors that are manageable today may become disqualifying under competitive bidding scrutiny.
- Understand true margins by product category. Many suppliers don’t have clean visibility into profitability once shipping, labor, denials, and rework are accounted for.
- Reduce rework and denials. Faster, cleaner claims cycles improve cash flow — and create breathing room if reimbursement tightens later.
- Evaluate operational scalability. Whether or not you plan to bid, understanding your ability to scale fulfillment and support is critical.
Businesses that are operationally disciplined long before pricing changes show up on the remittance advice will win at competitive bidding.
The next few years will likely separate providers who run lean, data-driven operations from those relying on margin buffers that no longer exist.