Suppliers may submit a provider enrollment appeal in the form of a corrective action plan (CAP) or reconsideration request for NPEAST DMEPOS suppliers to us. Please read this article for additional information.
A supplier whose Medicare billing privileges have been deactivated may file a rebuttal. A rebuttal is an opportunity for the provider or supplier to demonstrate that it meets all applicable enrollment requirements and that its Medicare billing privileges should not have been deactivated. Please read this article for additional information.
This notice informs stakeholders of an upcoming update to the processing responsibility for DMEPOS appeals and rebuttals. Effective May 8, 2026, the National Provider Enrollment DMEPOS enrollment contractors (NPEs) will assume responsibility for processing DMEPOS appeals and rebuttals for suppliers within their respective jurisdictions. Please read article for additional information.
Effective January 3, 2026, a new site verification service contractor began conducting site visits for applications processed by NPEAST. This transition is a one-time change that temporarily extends our processing timeline for any application that requires a site visit.
Due to the transition, we are experiencing delays in receiving results from the site verification service contractor. CMS and NPEAST are aware of the current delays and will continue working together on a resolution.
We appreciate your patience as we navigate this temporary challenge.
Effective January 1, the application fee is $750 for institutional providers who are:
Initially enrolling in the Medicare or Medicaid programs or the Children's Health Insurance Program (CHIP)
Revalidating their Medicare, Medicaid, or CHIP enrollment
Adding a new Medicare practice location
CMS requires this fee with any of these enrollment applications submitted from January 1 - December 31, 2026. See the notice for more information.
The 2026 annual participation open enrollment period will run through December 31, 2025. The open enrollment period allows Medicare suppliers to revisit their choice to accept Medicare assignment for claims payment. Participation status only affects how you are reimbursed from Medicare. Changing your status to non-participating does not terminate your Medicare billing privileges. For more information, please refer to our article.
We now have a DMEPOS licensure database for only the states and territories in the eastern jurisdiction (East of the Mississippi River). The database will appear and function very similarly to the licensure database you are accustomed to using. NPWest (Palmetto GBA) will continue to maintain a licensure database for all states and territories west of the Mississippi River. There will be links available on our website that will direct you to NPWest’s database if you also need to research states or territories in the western jurisdiction.
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