DMEPOS Competitive Bidding: Where the Program Stands and What It Means for Suppliers

Medicare’s DMEPOS Competitive Bidding Program is coming back after a gap that began January 1, 2024. Round 2028 covers seven product categories in one nationwide remote item delivery area, none of them mobility equipment; bidder registration opens December 1, 2026, the bid window runs January 5 to March 10, 2027, and contracts and single payment amounts take effect January 1, 2028.

This is the industry page. It is written for suppliers, manufacturers and the people who finance them.

What the program is

Congress created the program in the Medicare Modernization Act of 2003. CMS’s program page describes the mechanics: it “replaced the previous fee schedule payment method for selected DMEPOS items with a competitive bid process.” Suppliers submit bids through a web-based application. CMS evaluates “enrollment eligibility, financial stability, and bid price,” awards contracts to qualified suppliers, and pays a single payment amount (SPA) for each item in each competitive bidding area (CBA). Contract suppliers “must accept assignment on all claims for bid items.” Not every DMEPOS item is subject to bidding; CMS picks the product categories.

The payment effect reaches beyond the bid areas. Under 42 CFR 414.210(g), CMS must adjust fee schedule amounts for DME furnished outside CBAs using bid-derived prices. That is the channel through which a program with no mobility category still sets what a mobility supplier in a non-bid county gets paid.

History in six rounds

• Round 1 (2008) and the Round 1 Rebid (2011). Per the CBIC summary, Round 1 “was implemented in 2008 for two weeks until the contracts were terminated by subsequent law.” The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) delayed the program and voided the contracts. CMS re-ran the competition in 2009 as the Round 1 Rebid. Contracts took effect January 1, 2011 in nine CBAs for nine product categories and ended December 31, 2013.
• Round 2 and National Mail-Order (2013). Contracts took effect July 1, 2013 in 100 CBAs for eight product categories, after the Affordable Care Act expanded the Round 2 metropolitan areas from 70 to 91. The national mail-order program covered diabetic testing supplies. Both expired June 30, 2016. The Round 1 Recompete ran from January 1, 2014.
• Round 2 Recompete (2016). Contracts ran July 1, 2016 through December 31, 2018 across seven categories, including “Standard Mobility Equipment and Related Accessories.” CMS executed 586 contracts and reported about $3.6 billion saved in the first two years of Round 2 and mail-order.
• Round 2021. CMS competed 16 product categories in 130 CBAs. It removed non-invasive ventilators in April 2020 during the COVID-19 emergency. On October 27, 2020, CMS announced it was “not awarding competitive bidding contracts for any of the 13 product categories for Round 2021 that were previously competed because the payment amounts did not achieve expected savings.” Only off-the-shelf (OTS) back braces and OTS knee braces received contracts, in 127 CBAs, with expected savings of $600 million over three years. Those contracts ran January 1, 2021 to December 31, 2023.

The program’s regulatory trail, from the 2007 final rule CMS-1270-F through CMS-1828-F in 2025, is indexed on CMS’s regulations and notices page.

The gap period since 2024

CMS’s program page: “As of January 1, 2024, there’s a temporary gap period for the DMEPOS CBP.” No contracts are in force. Any enrolled supplier may furnish the formerly bid items.

Payment during the gap follows 42 CFR 414.210(g)(10) and the annual fee schedule instruction. MLN Matters MM14326 (revised January 30, 2026) explains: fees for items in a former CBA “are based on the SPAs in effect in the CBA on the last day before the CBP contract period of performance ended, increased by the projected percentage change in the CPI-U.” For 2026 that increase is 2.8%, following 2.9% in 2025. For items that were in Round 2021 but got no contract, CMS raised the 2025 adjusted amounts by the same 2.8%. Payment “is equal to 80% of the lesser of the supplier’s charge or the fee schedule amount.” Outside former CBAs, the 2026 update factor for amounts not adjusted through bidding is 2.0%: a 2.7% CPI-U increase less a 0.7% productivity adjustment.

Round 2028: what CMS has announced

CMS first laid out the next round in a fact sheet issued November 28, 2025 (updated December 8, 2025), then put dates on it October 7, 2026. Verified as of October 30, 2026 from the CBIC timeline and CMS’s MLN Connects newsletter of October 8, 2026:

Milestone	Date
Pre-bidding supplier awareness program	December 2025
Lead items announced	June 4, 2026
Contract counts per category announced	August 13, 2026
Registration and bid dates announced; CBIC customer service opens	October 7, 2026
Bidder registration opens	December 1, 2026
Bid window opens	January 5, 2027
Bidder registration closes	February 1, 2027
Covered Document Review Date	February 8, 2027
Bid window closes	March 10, 2027
Bona fide bid, preliminary bid, covered document and surety bond reviews	Late winter/spring 2027
Contract suppliers and SPAs announced	Late summer/early fall 2027
Contracts and SPAs in effect; six-month transition begins	January 1, 2028

The CBIC news release says CMS moved the registration and bid dates later than the original “later this year” plan to give bidders more preparation time. The six-month transition is the period in which contract suppliers obtain written orders from beneficiaries who had used non-contract suppliers before January 1, 2028.

Product categories. Seven, all placed in one Nationwide Remote Item Delivery (RID) CBA covering “all states, territories, and the District of Columbia”:

1. Class II continuous glucose monitors (CGMs) and insulin pumps
2. Urological supplies (excluding hydrophilic catheters)
3. Ostomy supplies
4. Hydrophilic urinary catheters
5. OTS back braces
6. OTS knee braces
7. OTS upper extremity braces

The RID fact sheet (June 4, 2026) defines the model: contract suppliers are “required to deliver or ship items to a beneficiary’s home,” with the option of pickup at a pharmacy or supplier location. Each included item “is already furnished primarily by suppliers from remote locations.”

Contract counts and pricing. The November 2025 fact sheet set the method: contracts per category equal 125% of the suppliers that furnished at least 3% of national allowed services for the lead item in 2025. CMS’s early estimates from 2024 data were about 10 contracts for CGMs and insulin pumps, 8 each for urological and ostomy, 6 each for OTS upper extremity and knee braces, and 4 for OTS back braces. SPAs “are now calculated using the 75th percentile of winning bids instead of the maximum winning bid,” and are updated by CPI-U in contract years two and three. CGMs and insulin pumps move to monthly rental payment; the CGM bid limit, using 2025 amounts, was $272.69 a month before the 2026 update factor.

Bid surety bond. The CBIC fact sheet updated October 7, 2026 states a bond of $100,000 for the RID CBP, “finalized” in the FY 2027 IRF PPS final rule effective October 1, 2026. One bond covers the nationwide area regardless of how many categories a supplier bids. Missing bond, disqualified bid. The bond is forfeited if a supplier is offered a contract with a composite bid at or below the median and declines. CMS’s November 2025 fact sheet had listed $50,000 per CBA, so bidders working from older material should re-check.

Small suppliers. If fewer than 30% of winning suppliers are small suppliers, CMS may offer additional contracts toward a 30% target.

The CY 2026 final rule behind it

CMS-1828-F, published December 2, 2025 at 90 FR 55342 and effective January 1, 2026, carried the competitive bidding rewrite inside the home health rule. The DMEPOS provisions, from the rule’s executive summary:

• SPAs set at “the 75th percentile of winning bids for the lead item” rather than the maximum winning bid.
• Non-lead item SPA ratios calculated “based on the 2015 fee schedule amounts for each specific area” for non-RID areas.
• An annual inflation update to SPAs “starting with year two of the DMEPOS CBP contracts.”
• Bid limits for previously bid items at “the most recent SPA for the items plus 10 percent,” not to exceed the unadjusted fee schedule amount.
• Ostomy, tracheostomy and urological supplies confirmed as items CMS may bid under section 1847(a)(2) of the Act, with “medical supplies” as a category separate from DME.
• The remote item delivery concept: items “typically furnished to beneficiaries” from remote supplier locations.
• No more tax return extracts, income statements, balance sheets or cash flow statements. Bidders submit a credit report, and the financial score no longer determines capacity.
• A covered-document notification: CMS tells bidders within 90 days after the review date if documents are missing, and they get 10 days to supply them.
• The bid surety bond process codified for all future rounds; a tribal exemption letting IHS and tribal facilities bill as non-contract suppliers; and authority for CMS to “unilaterally terminate or modify” contracts when a public health emergency disrupts access.

The same rule changed DMEPOS accreditation. CMS’s fact sheet: “DMEPOS suppliers will now have to be resurveyed and reaccredited annually,” replacing the three-year cycle, with more frequent data from accrediting organizations and expanded CMS oversight of them.

What it means for mobility suppliers and manufacturers

No mobility category in Round 2028. Standard mobility equipment was last under contract in the Round 2 Recompete, which ended December 31, 2018. The seven Round 2028 categories contain no wheelchairs, power mobility devices, walkers, seating or accessories. Under the announced Round 2028 categories, any enrolled supplier can keep furnishing them under the fee schedule.

The fee schedule still carries bid prices. Under 42 CFR 414.210(g), non-rural fee schedule amounts in the contiguous United States have been fully adjusted to bid-derived regional prices since January 1, 2024. Rural and non-contiguous areas receive a 50/50 blend of the adjusted amount and the updated 2015 fee schedule amount. Items that were in Round 2021 but got no contract carry 2025 amounts plus 2.8% in 2026. A mobility manufacturer pricing to Medicare in 2026 is pricing against fee schedule amounts derived from earlier rounds and trended by CPI-U, not against a fresh bid.

Watch the phasing language. CMS’s own FAQ title states it “will be phasing in remote item delivery (RID) competitive bidding programs.” The mechanics in CMS-1828-F (75th percentile pricing, credit-report-only financials, annual SPA updates) are now the template for any later round, whatever categories it names. Mobility is out of Round 2028; nothing in the rule says it is out for good.

Accreditation costs rise now. Annual resurvey applies to every DMEPOS supplier, not only bidders. Mobility dealers should budget for it from 2026.

The orthotics overlap. OTS back, knee and upper extremity braces are in Round 2028. Mobility dealers that also bill L codes for OTS orthoses will need a contract to furnish those items to Medicare beneficiaries from January 1, 2028, or stop furnishing them.

What changed recently

• October 8, 2026: CMS’s MLN Connects newsletter published the Round 2028 dates: “December 1, 2026: Bidder registration window opens” and “January 5, 2027: Bid window opens.”
• October 7, 2026: The CBIC posted the revised Round 2028 timeline (registration closes February 1, 2027; covered document review date February 8, 2027; bid window closes March 10, 2027), opened the customer service center, released the Request for Bids instructions, and updated the bid surety bond fact sheet to $100,000 for the RID CBA.
• October 1, 2026: The FY 2027 IRF PPS final rule provision setting the $100,000 RID bid surety bond took effect, per the CBIC fact sheet.
• August 13, 2026: CMS announced how many contracts it will award in each Round 2028 product category.
• June 4, 2026: CMS announced lead items for the Round 2028 categories and published the RID, lead item pricing and contract supplier obligation fact sheets.
• April 6, 2026: CMS’s competitive bidding program page was last modified; it still describes the gap period and links to the Round 2028 FAQ.
• January 30, 2026: MLN MM14326 (revised) set the 2026 gap-period update at 2.8% for former CBAs and 2.0% for non-bid-adjusted amounts.
• December 2, 2025: CMS-1828-F published in the Federal Register, effective January 1, 2026.
• November 28, 2025: CMS announced the next round and its seven product categories.

Where to check

• CBIC: Round 2028 Timeline
• CBIC: Round 2028 Fact Sheets and FAQs
• CBIC: Request for Bids Instructions (PDF)
• CMS: DMEPOS Competitive Bidding program page
• CMS: Fact Sheet, DMEPOS Competitive Bidding Program Updates
• Federal Register: CMS-1828-F (December 2, 2025)
• 42 CFR 414.210
• MLN MM14326: DMEPOS Fee Schedule CY 2026 Update (PDF)

The CBIC site is the official source for bidders. This page will be updated as CMS posts contract awards and SPAs in 2027.