CMS DMEPOS Enrollment Freeze

[Bored Snorlax]

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Hi everyone. Just saw the Dr. Oz clip about a "6-month national moratorium" on DME and wanted to sanity check what it means in real practice.

It looks like CMS is pausing new Medicare DMEPOS supplier enrollments for 6 months for certain supplier specialty types, including categories tied to orthotics, pedorthics, and prosthetics. It also seems to affect some majority ownership changes that trigger an “initial enrollment” type process. My read is that already enrolled suppliers generally keep operating, so this is mostly about new enrollments rather than cutting off current patients.

I’m trying to think through practical podiatry scenarios like post-op boots, AFOs/bracing, and offices that dispense DME.

Quick questions:

1. Do you expect any patient access issues where you are, like longer wait times, fewer local options, or more delays for post-op bracing and AFOs?
2. Who do you think gets squeezed most, new DPM offices that dispense DME, independent brace/DME suppliers, or O&P shops?
3. If you were starting or buying into a practice right now, would you change anything about your DME setup, supplier relationships, or compliance workflow?

Not trying to make this political. Just trying to understand patient access and practice operations. Appreciate any insight.

Moratoria page: Provider Enrollment Moratoria | CMS
Q&A: https://www.cms.gov/files/document/dme-moratorium-qa-02252026-pdf.pdf-0

 

[Hybrocure]

Well, Dr Oz can go **** himself. But since the turn of the year I’ve noticed insurances have been cracking down on DME

 

[Bored Snorlax]

Well, Dr Oz can go **** himself. But since the turn of the year I’ve noticed insurances have been cracking down on DME

Seems like insurers made DME their New Year’s resolution: deny more, spend less. You can feel the tightening already. Even if existing suppliers keep operating, the downstream issue is patient access: fewer local options, more shipping delays, and more “come back next month for your boot.” In smaller markets, that becomes a problem fast.

Curious whether podiatry’s alphabet soup leadership plans to weigh in on patient access and continuity of care, even if it’s just to flag unintended consequences. I’m also genuinely wondering whether delays getting boots/offloading/AFOs could translate into worse outcomes and more avoidable OR time.

On the bright side, the meme economy is about to hit record RVUs… I’d just rather not see patients pay for it.

 

[Hybrocure]

Seems like insurers made DME their New Year’s resolution: deny more, spend less. You can feel the tightening already. Even if existing suppliers keep operating, the downstream issue is patient access: fewer local options, more shipping delays, and more “come back next month for your boot.” In smaller markets, that becomes a problem fast.

Curious whether podiatry’s alphabet soup leadership plans to weigh in on patient access and continuity of care, even if it’s just to flag unintended consequences. I’m also genuinely wondering whether delays getting boots/offloading/AFOs could translate into worse outcomes and more avoidable OR time.

On the bright side, the meme economy is about to hit record RVUs… I’d just rather not see patients pay for it.

Of course. Someone walks into my office with a severe ankle sprain or nonop fracture I don’t want to tell them I have to wait until insurance approves it before I can give them a boot.

It’s criminal on the insurances end honestly. And shame on them for doing that. That’s something the patient needs the moment they come into my office not two weeks down the road.

Crackdown on DME is going to hurt podiatry hard. Particularly those who champ surgery as being a moneymaker because they can sell a CAM boot to offset crappy reimbursement for their foot surgeries and they’ll no longer be able to make money off of that.

 

[Bored Snorlax]

Of course. Someone walks into my office with a severe ankle sprain or nonop fracture I don’t want to tell them I have to wait until insurance approves it before I can give them a boot.

It’s criminal on the insurances end honestly. And shame on them for doing that. That’s something the patient needs the moment they come into my office not two weeks down the road.

Crackdown on DME is going to hurt podiatry hard. Particularly those who champ surgery as being a moneymaker because they can sell a CAM boot to offset crappy reimbursement for their foot surgeries and they’ll no longer be able to make money off of that.

Totally agree. Telling a bad ankle sprain or a nondisplaced fx to “wait for approval” is wild. When offloading is clinically indicated, it’s often day-one care, not a two-weeks-later luxury.

What you’re describing fits the bigger trend too. APMA has recently emphasized that PA delays worsen outcomes, and they even called out the Medicare therapeutic shoes for patients with diabetes benefit as an outdated documentation process that can turn into months-long delays.

Separate issue, same direction. The CMS moratorium is about new DMEPOS supplier enrollment, and certain majority ownership changes can get treated like a new enrollment. One key nuance from the CMS Q&A is: “CMS’ regulations do not permit exceptions to a moratorium for individual providers or suppliers.” You can appeal a denial, but it’s basically limited to whether the moratorium applies to your supplier type. Interesting contrast with the PA side, where CMS and the DME MACs are rolling out a “gold carding” style exemption for high-affirmation suppliers, even as PA keeps expanding for additional items (L1932 is on that list starting 4/13/2026).

My worry is that in smaller markets, if the enrollment hold limits new supplier capacity, it could tighten access even more on top of the PA squeeze. For context, CMS has used enrollment moratoria before (2013–2019), but those were generally state or local and focused on other supplier types. This one being nationwide makes me curious where the real-world pinch shows up first.

 

[air bud]

Totally agree. Telling a bad ankle sprain or a nondisplaced fx to “wait for approval” is wild. When offloading is clinically indicated, it’s often day-one care, not a two-weeks-later luxury.

What you’re describing fits the bigger trend too. APMA has recently emphasized that PA delays worsen outcomes, and they even called out the Medicare therapeutic shoes for patients with diabetes benefit as an outdated documentation process that can turn into months-long delays.

Separate issue, same direction. The CMS moratorium is about new DMEPOS supplier enrollment, and certain majority ownership changes can get treated like a new enrollment. One key nuance from the CMS Q&A is: “CMS’ regulations do not permit exceptions to a moratorium for individual providers or suppliers.” You can appeal a denial, but it’s basically limited to whether the moratorium applies to your supplier type. Interesting contrast with the PA side, where CMS and the DME MACs are rolling out a “gold carding” style exemption for high-affirmation suppliers, even as PA keeps expanding for additional items (L1932 is on that list starting 4/13/2026).

My worry is that in smaller markets, if the enrollment hold limits new supplier capacity, it could tighten access even more on top of the PA squeeze. For context, CMS has used enrollment moratoria before (2013–2019), but those were generally state or local and focused on other supplier types. This one being nationwide makes me curious where the real-world pinch shows up first.

Who took over this account? This is too much real information were used to memes that are slightly off...

 

[Carbon13]

Interesting. I'm building a new office in town this year and closing my previously leased location.
Wonder if I'll have to apply for a totally new DME license or if transferable?

Oh well, self pay boots for a while if so.

 

[Weirdy]

Interesting. I'm building a new office in town this year and closing my previously leased location.
Wonder if I'll have to apply for a totally new DME license or if transferable?

Oh well, self pay boots for a while if so.

Some Exclusions Listed to DME License Moratorium​

The moratorium does not apply to:

• Changes in practice location (except if the location is changing from a location outside the moratorium area to a location inside the moratorium area).
• Changes in provider or supplier information, such as phone number or address.
• Changes in ownership (except changes in ownership of home health agencies that would require an initial enrollment).
• Any application received by the Medicare contractor before the moratorium is imposed.

CMS said any DME supplier that experiences a non-exempt change in majority ownership within 36 months of its initial enrollment (or within 36 months of its most recent change) must enroll in Medicare as a new supplier, undergo a survey and become newly accredited. This means that the supplier’s new enrollment is an initial enrollment no less than if the supplier had never enrolled in Medicare before.
==========================================================
From an article.

 

[Weirdy]

A medical supply company “is considered a business whose principal function is to furnish DMEPOS supplies (regardless of supply type) directly to another party,” including via mail order, the CMS document reads. The moratorium appears to exclude pharmacies, hospitals, home health agencies and physician offices that supply DME.
==================
More from same article.

CMS Freezes DME Medicare Enrollment for 6 Months

WASHINGTON—The Trump administration is placing a six-month national moratorium on Medicare enrollment for durable medical equipment (DME) suppliers, it announced Wednesday, Feb. 25.

www.homecaremag.com

 

[Bored Snorlax]

Interesting. I'm building a new office in town this year and closing my previously leased location.
Wonder if I'll have to apply for a totally new DME license or if transferable?

Oh well, self pay boots for a while if so.

Good question. @Weirdy already did the heavy lifting and pulled the key exclusions from the notice. If you’re already enrolled and this is a true relocation under the same entity, as written the moratorium is aimed at new enrollments and new locations that require their own enrollment, not a straightforward address or practice location update. Since this is the first time it’s nationwide, I’d still do a quick check with the NSC or your DME MAC so you don’t get burned by a technicality.

I’d love to see ACFAS/APMA (or state societies) put out a quick “what this means for DPMs” explainer. DME is central to both clinic and post-op care, and when logistics get jammed up, patients feel it fast through delayed offloading and longer recoveries.

Who took over this account? This is too much real information were used to memes that are slightly off...

Fair shot 😂 Match and graduation left, so I’ve got too much free time. Four years of reading Feli’s novels basically turned me into an accidental author. Every now and then I do a policy deep dive instead of something truly productive like making memes... only to get humbled by Heybrother and a basketball playing dog reminding me this is an attending league. I’m just happy to sneak into the playoffs lol.

 

[air bud]

Good question. @Weirdy already did the heavy lifting and pulled the key exclusions from the notice. If you’re already enrolled and this is a true relocation under the same entity, as written the moratorium is aimed at new enrollments and new locations that require their own enrollment, not a straightforward address or practice location update. Since this is the first time it’s nationwide, I’d still do a quick check with the NSC or your DME MAC so you don’t get burned by a technicality.

I’d love to see ACFAS/APMA (or state societies) put out a quick “what this means for DPMs” explainer. DME is central to both clinic and post-op care, and when logistics get jammed up, patients feel it fast through delayed offloading and longer recoveries.


Fair shot 😂 Match and graduation left, so I’ve got too much free time. Four years of reading Feli’s novels basically turned me into an accidental author. Every now and then I do a policy deep dive instead of something truly productive like making memes... only to get humbled by Heybrother and a basketball playing dog reminding me this is an attending league. I’m just happy to sneak into the playoffs lol.

Fake it till you make it bro and you're doing a good job faking it... You're writing like your 10 years out with a well-seasoned mustache and a long time dispenser of better balance braces.

I'm just a simple hospital-based basketball playing dog.... Patient needs a camboot and I say cool here you go. If you're worried about insurance you can just buy the same one on Amazon for 55 bucks

 

[Weirdy]

Fair shot 😂 Match and graduation left, so I’ve got too much free time. Four years of reading Feli’s novels basically turned me into an accidental author. Every now and then I do a policy deep dive instead of something truly productive like making memes... only to get humbled by Heybrother and a basketball playing dog reminding me this is an attending league. I’m just happy to sneak into the playoffs lol.

See if you can dig any deeper.
I couldn't find raw material or anything on CMS website etc.

Maybe its out too new to release any "FYI" articles straight from CMS MACs etc

 

[ParNoMoney]

Two quick points: I wouldn't hold my breath waiting for the apma to respond to this and the stock and bill program works for me. Addendum: Amazon has been a good choice for DME. I help patients order the product in the treatment room on their phone, and within a day or two they have it.

 

[Sybly]

Who took over this account? This is too much real information were used to memes that are slightly off...

What is ridiculous is APMA! As podiatrist,why can’t we order shoes? If we not competent to do it we’re second rate in Medicare perceptive!! We are …

 

[Toenail]

What is ridiculous is APMA! As podiatrist,why can’t we order shoes? If we not competent to do it we’re second rate in Medicare perceptive!! We are …

This is an extremely important topic that you have brought to light.

 

[Bored Snorlax]

What is ridiculous is APMA! As podiatrist,why can’t we order shoes? If we not competent to do it we’re second rate in Medicare perceptive!! We are …

I’m starting to wonder if a podiatrist stole Dr. Oz’s girlfriend in a past life. First skin grafts, now DME. We’re getting shafted from every direction… meanwhile the insurance companies are eating GOOD this year while patients get less access and delayed care. This is a serious trend that needs to be addressed.

 

[heybrother]

1. Medicare gave a small, one time fee schedule increase this year to private practice physicians
2. I can't comment on the overall health of the health insurance market, but large corps are widely pulling MA plans out of markets because of losses due to increase tightening on MA plan billing/reimbursement. The Trump administration actually seems like its going to investigate UHC and they apparently (unless Trump caves) aren't going to give a fee schedule increase to the MA plans for like next year (the average increase is supposedly 0.09% which is considered flat)
3. Republican ***** politicians were previously lining up left and right to pen editorials for the WSJ on the virtue of MA. The ***** editorial board at the WSJ is still making bullsh*t claims that perhaps patients in MA plans do better because of some sort of better care that MA plans provide (they do not provide care).
4. Meanwhile, Trump is actually saying things like - stop giving money to insurance companies, give it to patients. That's still not going to work, but its a better way of thinking about it.
5. Medicare reimburses like $100 something for an $11 ASO type brace. They reimburse like $300 for a $25 boot. We should expect to see continued tightening on DME related services. But this apparently doesn't even apply to us. It applies to businesses with a primary purpose dispensing DME. Props to Weirdy.
6. The kind grafts people were/are billing for are mostly trash. We should WANT to see fraud taken out of the system. It steals reimbursement from the rest of us.
7. CMS believes that the change in graft reimbursement will save individuals on Medicare $11 in part B premiums per month. A lot of doctors treat Medicare like the gift that is always giving (even if the procedure reimbursement is blah) but Medicare costs money for patients. It has a low deductible, but it has a very real monthly cost. Part B has premiums. Part D has premiums. Their supplement has a cost unless they have some sort of retirement plan or Tricare. As the prices of these components continues to increase people are pushed into MA plans that then show up at your office claiming sorry - podiatrists only deserve 75% of Medicare.

 

[air bud]

What is ridiculous is APMA! As podiatrist,why can’t we order shoes? If we not competent to do it we’re second rate in Medicare perceptive!! We are …

How long have you been a podiatrist bro Like 40 years You've known we are second rate for a long time this is not breaking news

 

[Sybly]

1. Medicare gave a small, one time fee schedule increase this year to private practice physicians
2. I can't comment on the overall health of the health insurance market, but large corps are widely pulling MA plans out of markets because of losses due to increase tightening on MA plan billing/reimbursement. The Trump administration actually seems like its going to investigate UHC and they apparently (unless Trump caves) aren't going to give a fee schedule increase to the MA plans for like next year (the average increase is supposedly 0.09% which is considered flat)
3. Republican ***** politicians were previously lining up left and right to pen editorials for the WSJ on the virtue of MA. The ***** editorial board at the WSJ is still making bullsh*t claims that perhaps patients in MA plans do better because of some sort of better care that MA plans provide (they do not provide care).
4. Meanwhile, Trump is actually saying things like - stop giving money to insurance companies, give it to patients. That's still not going to work, but its a better way of thinking about it.
5. Medicare reimburses like $100 something for an $11 ASO type brace. They reimburse like $300 for a $25 boot. We should expect to see continued tightening on DME related services. But this apparently doesn't even apply to us. It applies to businesses with a primary purpose dispensing DME. Props to Weirdy.
6. The kind grafts people were/are billing for are mostly trash. We should WANT to see fraud taken out of the system. It steals reimbursement from the rest of us.
7. CMS believes that the change in graft reimbursement will save individuals on Medicare $11 in part B premiums per month. A lot of doctors treat Medicare like the gift that is always giving (even if the procedure reimbursement is blah) but Medicare costs money for patients. It has a low deductible, but it has a very real monthly cost. Part B has premiums. Part D has premiums. Their supplement has a cost unless they have some sort of retirement plan or Tricare. As the prices of these components continues to increase people are pushed into MA plans that then show up at your office claiming sorry - podiatrists only deserve 75% of Medicare.

Trash? Some podiatrists have collected 1 million plus off of it…Thanks goodness for ethics

 

[Toenail]

Trash? Some podiatrists have collected 1 million plus off of it…Thanks goodness for ethics

That just shows how extremely important shoes are in healthcare.

 

[Sybly]

That just shows how extremely important shoes are in healthcare.

Milllion off cellular tissue products, not shoes