DMEPOSSuretyBond.com — A Surety One, Inc. portal • Medicare & Medicaid supplier bond specialists ☎ (800) 373-2804 ✉ Underwriting@SuretyOne.com
42 CFR § 424.57(d) · CMS-Compliant Surety

The Bond That Keeps You Billing.

Every Medicare DMEPOS supplier — durable medical equipment, prosthetics, orthotics and supplies — must keep a $50,000 surety bond on file for each NPI as a condition of enrollment. No bond, no billing privileges. DMEPOSSuretyBond.com underwrites these bonds directly: single locations, multi-state chains, elevated bonds, dental sleep medicine practitioners, and applicants that other markets turn away. Quotes the same business day.

Email Underwriting
$50,000Base penal sum required for each NPI / location
1 or ManySeparate bonds per NPI, or one blanket bond covering all
Same DayUnderwriting acknowledgment on every complete submission
0 DeclinedStandard and non-standard programs — we offer terms that fit
The Plain-English Version

What a DMEPOS Surety Bond Actually Does

The DMEPOS bond is Medicare's way of guaranteeing it gets its money back. When CMS determines that a supplier owes an overpayment, a civil money penalty, or an assessment and the supplier does not pay, the government does not simply write it off — a licensed surety stands behind the supplier and makes CMS whole. DMEPOSSuretyBond.com is that surety.

Mechanically, the bond is a contract among three parties. The DMEPOS supplier is the principal. CMS — administering the requirement through the National Supplier Clearinghouse and the National Provider Enrollment contractors — is the obligee, the party being protected. The surety is the financial guarantor behind the whole arrangement. If the principal defaults, the surety pays CMS and then pursues the principal for reimbursement.

The requirement is continuous. Coverage must be in place when billing privileges are granted and must remain unbroken for as long as the supplier bills the program. A lapse or an uncured cancellation results in revocation of Medicare billing privileges — which for most suppliers means the revenue stops the same week.

A Three-Party Agreement

The supplier is bonded, CMS is protected, and the surety backs the promise with real capital.

What the Bond Pays

Unpaid overpayments, unpaid civil money penalties, and unpaid assessments arising during the bond term.

Continuous by Design

Coverage must never break. Replacement paper goes on file before any cancellation takes effect.

Non-Standard Underwriting Too

Damaged credit and thin files qualify through our non-standard program. We decline no application.

Coverage & Carve-Outs

Who Must File — and Who Is Exempt

The rule reaches every entity enrolling as a DMEPOS supplier, but Congress and CMS carved out specific professional categories. Getting the exemption analysis right before you buy — or before you skip buying — is worth ten minutes of reading.

Required

DMEPOS Suppliers of Every Stripe

Home medical equipment companies, respiratory and oxygen providers, mobility and complex rehab dealers, mastectomy fitters, ostomy and urological suppliers, diabetic supply firms, and pharmacies enrolled as DMEPOS suppliers. If you hold or seek a supplier number and bill Part B for DMEPOS items, the bond requirement presumptively applies to you.

Required · Growing Segment

Dentists — Dental Sleep Medicine

Dentists furnishing durable medical equipment and dental prosthetic devices — most commonly custom oral appliances for obstructive sleep apnea (HCPCS E0486) — and billing a CMS program must comply with the DMEPOS bond requirement; 42 CFR § 424.57 contemplates both the DME and the dental prosthetics these practices furnish. We underwrite dental sleep medicine practitioner bonds routinely. Read the full dental sleep medicine guide →

Potentially Exempt

Certain Licensed Professionals

Physicians and non-physician practitioners furnishing items only to their own patients as part of their professional service, qualifying physical and occupational therapists in private practice, and state-licensed orthotic and prosthetic personnel furnishing items solely through their own practice may be exempt. The conditions are specific — confirm before relying on an exemption.

Potentially Exempt

Government-Operated Suppliers

State- and federally-operated suppliers that have provided CMS a comparable guarantee against unpaid obligations may be relieved of the commercial bond requirement. The guarantee must be on file and accepted — the exemption is not automatic.

⚠ Elevated bonds: when $50,000 is not the number

CMS may direct a penal sum above the $50,000 base where a supplier's history warrants it — unpaid overpayments, prior civil money penalties, or adverse legal actions on the record. If you have received an elevated bond directive, do not shop it like a standard bond. Send us the directive itself; we underwrite elevated DMEPOS bonds against the actual exposure and structure terms accordingly.

Multi-Location Suppliers

The $50,000-Per-NPI Stack

Medicare requires $50,000 of bond penalty for each NPI for which billing privileges are sought or maintained. A chain doesn't buy one bond — it buys a stack. You can write an independent bond for each location, or a single blanket bond scheduling every NPI. We structure both, and for chains the blanket route usually wins on administration and price.

Size Your Program

Slide to the number of NPIs / locations your organization operates. This is aggregate penal sum — the premium is a fraction of it, quoted per file.

4 NPIs
Aggregate penal sum $200,000

Four locations × $50,000. At this size, a single blanket bond scheduling all four NPIs is typically cheaper to maintain than four separate bonds — one renewal, one rider when you add a location.

Getting Started

How to Apply

The process is deliberately light. Complete the online application on this page — or email your package to Underwriting@SuretyOne.com — and an underwriter opens your file the same business day.

Complete the Application

Use the online form on this site or the fillable PDF. Have your NSC PTAN, accreditation details, and NPI list for every location ready.

Attach Financials

A personal financial statement from the owner(s) and a current business financial statement of the DMEPOS operation. Commercial surety is unsecured credit — the financials drive the rate.

Review the Quote

You receive a firm quote sized to your NPI count and history. Applicants outside standard parameters are routed into our non-standard program — still fully CMS-acceptable.

Bond Issued and Filed

Once premium and signed indemnity are received, we issue the bond for filing with the enrollment contractor and deliver your executed copy. Coverage renews continuously unless you tell us otherwise.

What to Have Ready

  • DMEPOS Bond ApplicationOnline on this page, or fillable PDF
  • NSC PTAN & AccreditationAccreditation organization and date
  • NPI List — All LocationsEvery NPI the bond must schedule
  • Owner Personal Financial StatementRequired from each 10%+ owner
  • Business Financial StatementMost recent year-end or interim
  • Medicare Billing HistoryMost recent fiscal year billed amount
The Practitioner's Library

DMEPOS Bond Guides, Written by an Underwriter

Six deep-dive analyses of the obligation — the regulation, the exemptions, the multi-location mechanics, elevated directives, dental sleep medicine, and what happens when things go wrong. This is the reference material we hand to suppliers, practice consultants and enrollment counsel.

The RegulationThe § 424.57(d) Requirement, ExplainedStatutory origin in the Balanced Budget Act of 1997, the 2009 final rule, what the bond must guarantee, continuity and tail liability, and how the instrument is underwritten.Read the analysis → Coverage & Carve-OutsWho Must File — and Who Is ExemptThe covered universe from HME chains to pharmacies to dental practices, and a careful reading of all four exemption categories with their undoing conditions.Read the analysis → Chains & GroupsMulti-Location & Blanket Bond StrategyThe $50,000-per-NPI stack, blanket versus separate instruments, schedule riders, acquisitions and CHOWs, and how chain programs are actually priced.Read the analysis → Adverse HistoryElevated Surety BondsWhen CMS directs a penal sum above $50,000 in $50,000 increments — why most markets decline on sight, and how elevated files actually get placed.Read the analysis → Dental Sleep MedicineThe Dentist as Medicare SupplierOral appliances and dental prosthetics under § 424.57, the E0486 enrollment pathway, the exemption question answered, and same-day underwriting for dental practices.Read the analysis → PricingHow Much Does the Bond Cost?Premium as a fraction of penal sum, the five rate drivers, three illustrative applicant profiles, and the costs that are not premium.Read the analysis → Getting BondedThe Application ProcessThe complete file, indemnity signature rules by entity type, the same-day timeline, and the four preventable delays.Read the analysis → After IssuanceRenewal, Riders & ContinuityContinuous renewal mechanics, the revalidation bond audit, switching sureties without a gap, and the five events to report immediately.Read the analysis → When It Goes WrongClaims, Lapses & RevocationPayment on notice, indemnity and subrogation, the cancellation clock, revocation of billing privileges under § 424.535, and the emergency replacement playbook.Read the analysis →

🗺 State-by-State: Medicare + the Medicaid Overlay, All 52 Jurisdictions

The federal bond is uniform nationwide — but many state Medicaid programs impose their own DME provider security requirements, and Texas and Florida maintain long-established $50,000 Medicaid-side bonds of their own. Our jurisdiction index covers all fifty states, D.C. and Puerto Rico, with dual-program structuring guidance. Browse the state index →

Questions We Hear Every Week

DMEPOS Bond FAQ

What exactly is a DMEPOS surety bond?
It is a surety instrument required by 42 CFR § 424.57(d) as a condition of enrolling as a Medicare DMEPOS supplier and keeping billing privileges active. Three parties sign on: the supplier (principal), CMS (obligee), and the surety guaranteeing the supplier's program obligations. If the supplier leaves overpayments, civil money penalties or assessments unpaid, the surety pays CMS and then pursues the supplier.
How much is the bond?
The base penal sum is $50,000 per NPI. A supplier with one enrolled location needs one $50,000 bond. A supplier with twelve NPIs needs $600,000 of aggregate penalty — as twelve separate bonds or one blanket bond scheduling all twelve. Premium is a small fraction of penal sum and is driven by owner credit and business financials.
Separate bonds or one blanket bond for my chain?
Either satisfies CMS. The blanket bond usually wins for chains: one renewal date, one indemnity package, and adding a new location is a rider rather than a new bond. Separate bonds occasionally make sense where locations sit in different legal entities or an acquisition is planned for part of the chain.
What is an elevated surety bond and why did I get a notice about one?
CMS may require a penal sum above the $50,000 base where a supplier's record shows unpaid overpayments, civil money penalties or adverse legal actions. If you received an elevated bond directive, send us the directive itself — we underwrite against the actual stated exposure rather than declining on sight.
What happens if my bond cancels or lapses?
Continuous coverage is a condition of enrollment. An uncured lapse results in revocation of Medicare billing privileges, and re-enrollment after revocation is far more painful than maintaining coverage. If you have received a cancellation notice from your current surety, contact us immediately — replacement paper must be on file before the cancellation takes effect.
I'm a dentist providing sleep apnea appliances. Does this apply to me?
If you furnish durable medical equipment — including custom oral appliances for obstructive sleep apnea — and bill a CMS program, the DMEPOS bond requirement applies unless you fit a stated exemption. Dental sleep medicine is one of our most active DMEPOS classes; the application on this page covers everything the enrollment contractor needs.
My credit is rough. Can I still get bonded?
Yes. Commercial surety bonds are essentially unsecured credit instruments, so personal credit matters to rate — but we maintain non-standard programs for applicants with damaged credit or no developed credit history. We decline no application; we offer terms that fit each applicant.
How fast can the bond be issued?
Complete standard files are typically quoted the same business day and issued upon receipt of premium and signed indemnity. Blanket bonds and elevated bonds may take an additional day while financial statements are reviewed. Enrollment deadlines and revocation cures are flagged and handled first.
How much does the bond cost per year?
Premium is a small fraction of the $50,000 penal sum. Standard-credit applicants on a single bond typically pay in the low hundreds of dollars annually; impaired credit prices higher through our non-standard program. The five rate drivers — owner credit, business financials, Medicare history, program size, and structure — are laid out in full on our cost page.
Do I also need a separate state Medicaid bond?
Possibly. A number of state Medicaid programs impose their own surety bond or security requirements on DME providers as a condition of state enrollment — Texas and Florida maintain long-established $50,000 Medicaid-side bonds, for example. These are separate instruments from the Medicare bond, running to the state as obligee. See our state-by-state index; dual-program suppliers get both instruments quoted in one response.
Does the bond renew automatically?
Yes — DMEPOS bonds are continuous instruments that renew on payment of the annual premium, without re-execution or re-filing. The practical risk is a missed invoice maturing into a cancellation notice, so the renewal belongs on the same compliance calendar as accreditation. Our renewal and continuity guide covers the full post-issuance lifecycle.
Can I switch sureties mid-term without risking my enrollment?
Yes, if sequenced correctly: replacement bond secured and filed first, contractor's record confirmed, and only then the prior bond terminated. Run in the other order, you are betting your billing privileges on the gap. Note that switching never erases history — the outgoing surety retains liability for obligations that arose during its term.
Who signs the indemnity agreement?
It follows entity type: the individual and spouse for sole owners; all partners and their spouses for partnerships; the president plus all stockholders holding ten percent or more, and their spouses, for corporations. Large and well-capitalized enterprises may qualify for waiver of personal indemnity on corporate financial strength.
Is collateral required?
Not on standard files. Collateral appears on non-standard placements where credit or Medicare history warrants it — most commonly partial collateral tied to an elevated increment or an unamortized repayment balance, structured to release as the exposure resolves. Even fully collateralized placements deliver a CMS-acceptable bond that keeps billing privileges intact.
What happens to my bond at revalidation?
Revalidation is where dormant bond defects surface — unridered locations, entity conversions that never reached the bond, name mismatches. Treat every revalidation notice as the trigger for a bond audit: compare the bond's principal name and NPI schedule to the enrollment record line by line, and cure variances before the response is filed. We run this comparison for our principals as routine service.
What does the surety actually pay CMS for?
Unpaid overpayments determined against the supplier, unpaid civil money penalties, and unpaid assessments — with accrued interest — arising from the supplier's Medicare activity during the bond term, up to the penal sum, on CMS's written notice. The surety then recovers in full from the supplier and its indemnitors, which is why the bond protects the government, not the supplier.

Let's Keep You Billing.

Start the application below, or send your package and financials to underwriting and we will open the file today. Standard and non-standard programs, single locations through national chains, handled under one roof.

Call (800) 373-2804