Novitas Solutions (NPEAST DMEPOS) recently published a reminder to suppliers of Durable Medical Equipment, Prosthetics and Orthotics, and Supplies (“DMEPOS”) about unannounced site visits. Specifically:
- DMEPOS suppliers must permit CMS or its agents to conduct unannounced site visits to confirm the supplier’s compliance with the DMEPOS standards.
- CMS or its agent may visit a supplier at any time during initial enrollment, reactivation, change of information, or when otherwise deemed necessary.
- CMS or its agent will carry a photo ID and a CMS-issued signed authorization letter suppliers may review to verify that CMS ordered a site visit.
- Qualified staff should be available to answer questions and access requested documentation during the site visit.
- A refusal of the site visit can result in denial, deactivation, or revocation of Medicare billing privileges.
DMEPOS suppliers have historically faced scrutinous review with respect to Medicare enrollment. In the last year, Advis has seen several examples of initial Medicare enrollment denials or revocation of billing privileges for existing suppliers due site visit issues. Those issues typically stem from supplier staff who were unable to provide requested documentation or information to the surveyor. In some cases, there is miscommunication between the surveyor and supplier staff about a request for documentation needed as part of the site visit.
Site visits continue to be a priority for CMS and its enforcement of DMEPOS requirements. Therefore, Advis recommends reviewing its tips (here) for DMEPOS suppliers to maintain compliance.
Advis has extensive experience in Medicare enrollment matters, including preparation of corrective action plans and reconsideration requests in the event of negative site visit or other findings. For any questions concerning the above, please contact your Advis consultant for more information.
Published June 10, 2025
