Enrollment as a DME Supplier with Medicare (PECOS)
Feb 01, 2021
I get asked regularly about enrollment with Medicare to supply DME, including custom orthoses, to our patients. For today, suffice it to say that the process of enrolling through PECOS is not terrifically intuitive.
A couple of quick answers:
- Yes, we need to enroll through PECOS to bill Medicare for the L-codes that describe the orthoses we make.
- And no, we do not need to do that step for most other commercial payers (there may be some exceptions regionally**).
- And no, mobile practices are not eligible to apply. Unfortunately.
Here is an enrollment tutorial for initial enrollment for an organization.
Here is an enrollment tutorial for initial enrollment for an individual provider.
In the "checklist" of things needed to apply, there is a step that is potentially confusing... and costly (like $5k costly!). It lists "accreditation" as an orthotic supplier as a requirement.
Here is an enrollment tutorial for initial enrollment for an individual provider.
In the "checklist" of things needed to apply, there is a step that is potentially confusing... and costly (like $5k costly!). It lists "accreditation" as an orthotic supplier as a requirement.
This document explains the *exemptions* for the accreditation and surety bond steps.... which includes OTs and PTs. Check out the bottom of page 3, and the table on page 4.
Hope that is helpful to see it in writing!
