How to Get a DME PTAN: A Physician's Step-by-Step Guide to CMS-855S

You've decided your practice should bill Medicare for the braces, boots and supplies you hand patients every day. Great! Now comes the part nobody loves: the CMS-855S. It runs 27 pages, some sections are skipped, some must be duplicated, and a single missing attachment can send the whole application back. Don't worry, we'll walk you through it.

The short answer: To get a DME PTAN, a physician practice enrolls as a DMEPOS supplier by submitting the CMS-855S (online through PECOS is fastest), paying the $750 application fee for 2026, and passing an unannounced site visit. Physicians skip accreditation and, when serving only their own patients, the surety bond. Applications average about 90 days, but practices east of the Mississippi River have been waiting more than six months.

Step 1: Confirm what you'll furnish

List the items you plan to dispense and confirm each one is allowed: your state licensure rules, Medicare coverage, and Stark Law's in-office exceptions. The 855S asks which product categories you'll supply, so this list drives the whole application.

Step 2: Gather your documents

• NPI and practice details for each location that will furnish DMEPOS (every location needs its own enrollment)
• State professional licenses and any state DME or business licenses
• General liability insurance of at least $300,000, with the National Provider Enrollment (NPE) contractor listed as certificate holder. Malpractice coverage does not count.
• IRS documentation for the practice's legal business name and EIN
• Ownership information for every owner tied to the EIN, including full name, date of birth and Social Security number
• Bank information for the CMS-588 EFT form, including a voided check in the legal business name
• Posted business hours that match what you report on the application

Step 3: Submit the CMS-855S

Submit through PECOS for faster processing and fewer development requests. Applications go to NPE East (Novitas) or NPE West (Palmetto GBA) based on location. Pay the application fee by card or e-check; CMS won't start processing until it clears.

Step 4: Complete fingerprinting

New DMEPOS suppliers can be asked for fingerprint-based background checks. If requested, all owners tied to the EIN must be fingerprinted at an authorized Accurate Biometrics location, even owners who don't plan to dispense. Do this as soon as the request arrives; it's one of the most common causes of delay.

Step 5: Prepare for the site visit

A National Site Visit Contractor inspector will arrive unannounced during your posted hours. They'll photograph the outside and inside of the location and confirm you're open, staffed and set up as described. Make sure your hours are posted, keep examples of the products you'll dispense on hand, and let your front desk know a visit may come.

Step 6: Respond to development requests fast

If the contractor needs more information, you'll get a development request with a deadline. Missing it can mean a rejection and starting over. This is where most delays happen.

Step 7: Receive your DME PTAN

Once approved, you'll receive your DME PTAN. The contractor updates the claims system within one to two days, and you can begin billing your DME MAC. Remember: the PTAN must be awarded before you dispense or bill.

After approval: staying enrolled

• Report changes within 30 days (ownership, address, insurance, licenses)
• Revalidate every three years. CMS posts due dates six to seven months ahead.
• Keep billing. Suppliers with no claims for an extended period can be deactivated.
• Follow the 30 supplier standards and DMEPOS Quality Standards every day, not just at the site visit.

How long does it take?

Once the application is submitted in PECOS, it averages about 90 days. Medicare analysts review it first, then assign an inspector for the onsite visit, then issue the PTAN within a few weeks if everything checks out. Practices west of the Mississippi River (Palmetto GBA) are often seeing shorter times. East of the Mississippi, Novitas has been taking more than six months, so start early.

The most common mistakes we see

1. Listing professional or malpractice insurance instead of general liability
2. Leaving the NPE contractor off the insurance certificate
3. Posted hours that don't match the application, leading to a failed site visit
4. Owners who delay fingerprinting
5. Missing a development request deadline

Let us handle the paperwork

Our Medicare Application Team has prepared CMS-855 applications for 20 years. You complete one web-based questionnaire that only asks what applies to your practice, and most of it can be handled by your office manager. We prepare the 855S, check it against these common errors, and stay with you through approval. You keep seeing patients; we keep you stress free and in compliance! See what's included, what it costs and whether you're eligible on our Medicare PTAN Enrollment Service for Physicians page.

Not sure a DME PTAN is right for you yet? Start with Why Physician Practices Need a DME PTAN. Ready to start? Talk to our Medicare Application Team, email sales@rjhedges.com or call (724) 357-8380.

Let's Get Your DMEPOS Medicare PTAN

Frequently asked questions

How long does it take to get a DME PTAN?
About 90 days on average after submission. West of the Mississippi River is often faster; east of the Mississippi, Novitas has been taking more than six months.

Do all owners need to be fingerprinted?
If CMS requests it, yes. Every owner tied to the EIN must complete fingerprinting at an authorized Accurate Biometrics location, even owners who don't dispense.

Can I submit the CMS-855S on paper?
Yes, but PECOS is faster and leads to fewer development requests.

Does each office location need its own DME PTAN?
Yes. Each location that furnishes DMEPOS to Medicare patients must be enrolled, and the fee applies per location.

Is the site visit announced?
No. Inspectors arrive unannounced during the hours you list on the application.

How often do I revalidate?
Every three years.

Who processes physician DME applications?
The National Provider Enrollment contractors: NPE East (Novitas) east of the Mississippi River and NPE West (Palmetto GBA) west of it.