This glossary provides key terms and definitions to help Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers understand the DMEPOS Competitive Bidding Program (CBP) for Round 2028. It is provided for general informational purposes only and is not intended to replace or supersede applicable Medicare statutes or regulations.
Adjusted Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Amount: A fee schedule amount that has been adjusted based on competitive bidding information.
Authorized Official (AO): For Medicare enrollment and Connexion, the DMEPOS CBP’s secure portal, the AO must be an individual identified as an AO on the CMS-855S Medicare Enrollment Application. This individual is an appointed official for the organization (for example, chief executive officer, chief financial officer, general partner, chairman of the board, or five percent or greater direct owner) to whom the organization has granted the legal authority to enroll it in the Medicare program, to make changes or updates to the organization’s enrollment information in the Medicare program, and to commit the organization to fully abide by the statutes, regulations, and program instructions of the Medicare program.
In Connexion, the AO may approve or reject requests from backup authorized officials (BAOs) and end users (EUs) to: 1) access and enter data, and 2) access, upload, and complete specific information in Connexion. CMS will only accept bids that are approved and certified by the AO and any registered BAO on behalf of the organization. CMS will only allow AOs and registered BAOs to enter into a contract with Medicare to furnish competitively bid lead items and non-lead items in the product category to Medicare beneficiaries.
Authorized Surety: A company that has been issued a Treasury Certificate of Authority by the U.S. Department of the Treasury to act as an acceptable surety on federal bonds. See the Bid Surety Bond fact sheet for more information.
Backup Authorized Official (BAO): A BAO is an individual identified as an authorized official (AO) on the CMS-855S Medicare Enrollment Application and who can serve as a backup to the AO for certain activities within the DMEPOS CBP. During bidding, a BAO can assist the AO with bidding activities and/or serve as the AO should the AO leave the organization or become unavailable during the bid window. Within Connexion, the DMEPOS CBP’s secure portal, a BAO has the ability to view, upload and approve all bidding and contract information, and upload and approve contract maintenance forms.
Beneficiary: A person who has health care insurance through the Medicare program.
Bid: An offer to furnish an item or items for a particular price and time period that includes, where appropriate, any services that are directly related to the furnishing of the item or items. The bidder should consider all costs associated with furnishing an item or items.
Bid Limit: The maximum amount a bidder may bid for a lead item in a product category. See the Lead Item Bidding and Pricing fact sheet for more information.
Bid Price/Amount: The amount a bidder offers to furnish a competitively bid lead item to Medicare beneficiaries in a specific competitive bidding area (CBA) as part of the DMEPOS CBP. The bid amount must be bona fide for each item (identified by the Healthcare Common Procedure Coding System (HCPCS) code) in accordance with 42 CFR § 414.414(b)(4). It should be rational, feasible, and supportable, include the cost of furnishing the item throughout the CBA (except for skilled nursing facilities and nursing facilities that elect to participate as specialty suppliers) for the duration of the contract performance period, and include overhead and profit. See the Lead Item Bidding and Pricing fact sheet and the Requirements to Submit a Bona Fide Bid fact sheet for more information.
Bid Surety Bond: A bond in which a surety financially guarantees to an obligee (in this context, CMS) that the principal (bidding entity) will act in accordance with the terms established by the bond. See 42 CFR § 414.412(g) for a description of the bid surety bond requirements. See the Bid Surety Bond fact sheet for more information.
Bid Window: The period of time during which the bidder can submit bids for consideration in a DMEPOS CBP round. No bids are accepted after the bid window closes.
Bidder Number: System-generated number that identifies each unique bidding entity, assigned after the bidder completes the Business Organization Information section of Form A of the bid.
Bidding Entity: The entity whose legal business name is identified in the Form A Business Organization Information section of the bid.
CMS-Approved Accrediting Organization: An organization that has been approved by CMS to accredit suppliers of DMEPOS items. A listing of approved accrediting organizations can be found by visiting the CMS website.
CMS Enterprise Portal: A single point of entry to numerous CMS applications, systems, and databases.
Common Control: Suppliers are commonly controlled if one or more of a supplier’s owners are also an officer, director, or partner in another supplier. See the Common Ownership and Common Control fact sheet for more information.
Common Ownership: Two or more suppliers are commonly owned if one or more of them have an ownership interest totaling at least five percent in the other(s). The term "ownership interest" is defined as "the possession of equity in the capital, stock, or profits of another supplier." See the Common Ownership and Common Control fact sheet for more information.
Competition: A competitive bidding area (CBA) and product category combination for which a bidding entity submits a bid and for which a supplier enters into a DMEPOS CBP supplier contract to furnish items and services within the product category to beneficiaries residing within the CBA.
Competitive Bidding Area (CBA): An area established for the purposes of the DMEPOS CBP. The area may be as large as the entire country or as small as a portion of a metropolitan statistical area. For Round 2028, see the Competitive Bidding Area fact sheet.
Competitive Bidding Implementation Contractor (CBIC): The CMS contractor responsible for conducting certain functions, including assisting CMS with performing bid evaluations, supporting CMS's education efforts, and monitoring the DMEPOS CBP.
Competitive Bidding Program (CBP): A program where CMS solicits bids from qualifying suppliers, establishes single payment amount(s), and awards contracts within a designated competitive bidding area.
Composite Bid: The bid submitted by a supplier for the lead item in the product category.
Contract Supplier: An entity awarded a contract by CMS to furnish items under the DMEPOS CBP.
Connexion: The DMEPOS CBP’s secure portal for suppliers to submit a bid, upload bidding documents, view and respond to contract offers, and to complete and submit forms required to update contract information.
Covered Document: A financial, tax, or other document required to be submitted by a bidder as part of an original bid submission under a competitive acquisition program to meet the required financial standards. For Round 2028, the covered document is the required credit report with a numerical credit score or rating.
Covered Document Review Date (CDRD): The date by which required financial documents must be uploaded in Connexion, the DMEPOS CBP’s secure portal, for the documents to be reviewed and for the bidder to be notified of any missing financial documents. The CDRD is the later of the date that is 30 days before the final date for the closing of the bid window or the date that is 30 days after the opening of the bid window. Bidders who submit a covered document by the CDRD are provided an opportunity to submit any missing covered documents not received by the Competitive Bidding Implementation Contractor (CBIC) by the end of the bid window.
DMEPOS Fee Schedule: A schedule or list of amounts used in determining the Medicare Part B allowed payment amounts for DMEPOS items and services that are not included in the DMEPOS CBP or are furnished to beneficiaries who reside or travel to an area not part of a competitive bidding area (CBA). The Medicare allowed payment amount is based on the lesser of the supplier’s actual charge or the fee schedule amount. See 42 CFR, Part 414, Subparts C and D for more information regarding the DMEPOS fee schedules.
End User (EU): The EU is someone whom the organization trusts to conduct company business and can assist the authorized official (AO) and backup authorized official (BAO) by entering and uploading bid information in Connexion, the DMEPOS CBP’s secure portal, but has limited capabilities. A delegated official (DO) listed on the enrollment application must register and perform as an EU. In the bidding section of Connexion, CMS grants EUs the ability to enter data on Form A and Form B, but an EU does not have the authority to approve Form A or certify Form B. The EU has limited capabilities, but can upload bidder documents, view and print contract documents, and complete specific contract maintenance forms. An organization can have one or more EUs.
Grandfathered Item: All rented items within a product category for which payment was made prior to the implementation of a DMEPOS CBP to a grandfathered supplier that chooses to continue to furnish the items in accordance with 42 CFR § 414.408(j), and that fall within a payment category described in 42 CFR §§ 414.220, 414.222, 414.226, and 414.229.
Grandfathered Supplier: A non-contract supplier that chooses to continue to furnish grandfathered items to a beneficiary in a competitive bidding area (CBA).
Healthcare Common Procedure Coding System (HCPCS): A standardized coding system used to process certain claims, including those for DMEPOS items and services, submitted to Medicare, Medicaid, and other health insurance programs by providers, physicians, and other suppliers.
Item: A product included in the DMEPOS CBP that is identified by a Healthcare Common Procedure Coding System (HCPCS) code, which may be specified for competitive bidding, or a combination of codes and/or modifiers and includes the services directly related to the furnishing of that product to the beneficiary. Items that may be included in the DMEPOS CBP are:
- Durable medical equipment (DME), other than class III devices under the Federal Food, Drug and Cosmetic Act; group 3 complex rehabilitative wheelchairs, complex rehabilitative manual wheelchairs, certain other manual wheelchairs; and related accessories when furnished in connection with such wheelchairs, and further classified into the following categories:
- Inexpensive or routinely purchased items, as specified in 42 CFR § 414.220(a).
- Items requiring frequent and substantial servicing, as specified in 42 CFR § 414.222(a).
- Oxygen and oxygen equipment, as specified in 42 CFR § 414.226(c)(1).
- Other DME (capped rental items), as specified in 42 CFR § 414.229.
- Supplies necessary for the effective use of DME other than inhalation and infusion drugs.
- Enteral nutrients, equipment, and supplies.
- Off-the-shelf orthotics, which are orthotics described in Section 1861(s)(9) of the Social Security Act (the Act) that require minimal self-adjustment for appropriate use and do not require expertise in trimming, bending, molding, assembling, or customizing to fit a beneficiary.
- Lymphedema compression treatment items.
- Other medical equipment described in Section 1861(m)(5) of the Act, including supplies related to ostomy care and urological supplies.
Lead Item: The item in a product category with multiple items with the highest total nationwide Medicare allowed charges of any item in the product category prior to each competition. See the Lead Item Bidding and Pricing fact sheet for more information.
Lead Item Pricing: A DMEPOS CBP methodology that establishes the single payment amounts (SPAs) for competitive bidding items based on the 75th percentile of winning bid amounts for the lead item in each competitive bidding area and product category combination (competition). Suppliers submit one bid amount for furnishing the lead item Healthcare Common Procedure Coding System (HCPCS) code, while the SPAs for the non-lead item HCPCS codes within the competition are determined by multiplying the lead item SPA by a relative ratio. The ratios are based on the historic differences in the fee schedule amounts for the lead item and non-lead items. The lead item pricing methodology is set forth at 42 CFR §§ 414.414 and 414.416. See the Lead Item Bidding and Pricing fact sheet for more information.
Medicare Advantage Plan: A type of Medicare health plan offered by a private company that contracts with Medicare to provide beneficiaries with Part A and Part B benefits. Medicare services are covered by the plan and aren’t paid for under Original Medicare. Medicare Advantage plans, commonly referred to as Part C, include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
National Provider Enrollment (NPE) regional DMEPOS contractors: CMS has two NPE regional DMEPOS contractors responsible for processing Medicare enrollment applications for DMEPOS suppliers to ensure they meet all supplier standards and enrollment requirements, issuing or revoking Medicare supplier billing privileges for suppliers of DMEPOS items and services, and processing DMEPOS appeals and rebuttals for suppliers within their respective jurisdictions:
- National Provider Enrollment Eastern Region DMEPOS contractor (NPEAST): The CMS contractor that is responsible for the following U.S. states and territories:
- Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, and U.S. Virgin Islands
See the NPEAST website for more information.
- National Provider Enrollment Western Region DMEPOS contractor (NPWEST): The CMS contractor that is responsible for the following U.S. states and territories:
- Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, and Northern Mariana Islands
See the NPWEST website for more information.
National Provider Identifier (NPI): A unique, 10-digit, sequentially assigned national identification number that is mandated by The Health Insurance Portability and Accountability Act of 1996 (HIPAA) to be used by health care providers, health plans, and health care clearinghouses in all administrative and financial HIPAA transactions.
Network: A group of between two and 20 small suppliers that form a legal entity to provide competitively bid lead and non-lead items throughout an entire competitive bidding area (CBA). These suppliers must certify they cannot independently furnish all competitively bid lead and non-lead items in the product category to beneficiaries throughout the entire geographic area of the CBA for which the network is submitting a bid. The network collectively submits a bid as a single entity. See the Small Supplier Considerations fact sheet for more information.
Original Medicare: Fee-for-service coverage under which the government pays health care providers directly for a beneficiary’s Part A and/or Part B benefits.
Parent-Subsidiary: Separate entities where one entity has ownership and control of another entity. In general, a parent entity is a company that owns controlling interests in one or more companies. A subsidiary is a company that is controlled by a parent company.
Pricing, Data Analysis, and Coding (PDAC) Contractor: CMS contractor responsible for providing suppliers and manufacturers with assistance in determining which Healthcare Common Procedure Coding System (HCPCS) code should be used to describe DMEPOS items for the purpose of billing Medicare. See the PDAC website for more information.
Primary Network Member: The network member that submits a bid on behalf of the network.
Provider Enrollment, Chain, and Ownership System (PECOS): The Internet-based application that can be used in lieu of the Medicare enrollment application (CMS-855S) to enroll, view or change enrollment information, track the enrollment application process, add or change a reassignment of benefits, submit changes to existing enrollment information, reactivate an existing enrollment record, or withdraw from the Medicare Program. See the PECOS website for more information.
Provider Transaction Access Number (PTAN): A Medicare enrollment alphanumeric identifier assigned to each supplier location.
Remote item delivery (RID) competitive bidding program (CBP): A competitive bidding program through which DMEPOS CBP suppliers (contract suppliers) are responsible for furnishing remote item delivery items under a product category to all Medicare beneficiaries regardless of where they live in the competitive bidding area (CBA). The CBA could be one nationwide CBA that includes all areas (all states, territories, and the District of Columbia) or a CBA covering a specific region of the country. See the Remote Item Delivery Competitive Bidding Program fact sheet for more information.
Remote item delivery (RID) item: An item falling under an RID competitive bidding program (CBP) that may be shipped or delivered to a beneficiary's home, regardless of the method of delivery, or picked up at a local pharmacy or supplier storefront if the beneficiary or caregiver for the beneficiary chooses to pick the item up in person. See the Remote Item Delivery Competitive Bidding Program fact sheet for more information.
Request for Bids (RFB) Instructions: A part of the formal process by which CMS requests eligible Medicare DMEPOS suppliers to submit bids for the amount for which they would furnish items and services included in the DMEPOS CBP, as well as certain required documents that demonstrate the bidder meets applicable financial and eligibility requirements.
Single Payment Amount (SPA): Allowed payment for an item furnished under a DMEPOS CBP. See the Determining the Number of Contract Awards and Calculating a Single Payment Amount fact sheet for more information.
Small Supplier: A supplier that generates gross revenue of $3.5 million or less in annual receipts including Medicare and non-Medicare revenue. See the Small Supplier Considerations fact sheet for more information.
Subcontractor: An entity that has an agreement with a contract supplier to supply specific services allowed under the DMEPOS Supplier Standards either to a contract supplier or directly to the beneficiary. Medicare payment is made to the contract supplier for the cost of the service. See the Subcontracting of DMEPOS Services fact sheet for more information.
Unadjusted DMEPOS Fee Schedule Amount: The applicable fee schedule amount without any adjustments based on competitive bidding information.
Source note: The DMEPOS CBP regulations have been amended through multiple rulemakings, including most recently in the Calendar Year 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) and the Fiscal Year 2027 Inpatient Rehabilitation Facility Prospective Payment System Final Rule (CMS-1845-F).