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Printed Date: 9/22/2015
CMS has deemed that suppliers providing drugs and pharmaceuticals only are not required to be accredited to obtain/maintain Medicare billing privileges. If suppliers bill for DMEPOS outside of pharmaceuticals, including products to administer drugs or pharmaceuticals, accreditation will be required to maintain Medicare billing privileges.
Pharmacy suppliers choosing to provide pharmaceuticals only must update their file with the National Supplier Clearinghouse (NSC) to reflect the products and services that will be provided to Medicare beneficiaries. Sections that should be submitted to the NSC are 1A, 3A, 3B,3C, 11, and 14 or 15 of the CMS 855S enrollment form. Suppliers found to be in violation by billing for other products or services will be subject to appropriate actions up to and including revocation.
As of January 1, 2011, pharmacies that meet all criteria may file an accreditation exemption statement which enables them to be enrolled in Medicare to supply durable medical equipment, orthotics, prosthetics and supplies (DMEPOS) which require accreditation, without having an accreditation. The exemption criteria is attached.
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Last Updated: 09/11/2019