HHZ Respiratory Review

Medicare DME assignment explained (2026)

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A DME supplier that accepts assignment takes the Medicare-approved amount as full payment, so you pay only the Part B deductible and 20% coinsurance, and it files the claim for you. A participating supplier must accept assignment. A non-participating supplier may decline, and CMS says such suppliers in non-bidding areas can charge any amount. For rented CPAP or oxygen, ask whether the supplier accepts assignment for every rental month. Sources: Medicare.gov and CMS, checked 13 October 2026.

Sources: Medicare.gov Does your provider accept Medicare as full payment? and DME coverage; CMS competitive bidding fact sheet. Checked 13 October 2026.

Three kinds of supplier

Supplier typeWhat you payClaims
Participating (always accepts assignment)Part B deductible + 20% of the approved amountSupplier files; can’t charge for filing
Non-participating, accepts assignment for youSame as above, case by caseSupplier files
Non-participating, doesn’t accept assignmentMay pay in full up front; can be charged moreSupplier should still file; you can file yourself if it refuses
Opted out of MedicareMedicare won’t pay (except emergencies); private contractNone

Medicare.gov says providers who opt out do so for at least 2 years.

Why it matters for DME

Medicare.gov’s general 15% “limiting charge” describes non-participating health care providers. For DME, CMS says non-participating suppliers in non-bidding areas aren’t required to accept assignment and “can charge any amount.” Medicare also pays only for DME from suppliers enrolled in Medicare (Medicare.gov).

Rentals: ask about every month

CPAP and oxygen are usually rented. Medicare.gov advises making sure the supplier accepts assignment for all rental months; otherwise you may have to pay the full cost up front and wait for Medicare to reimburse its share.

Questions to ask before you sign

  1. Are you enrolled in Medicare?
  2. Do you participate in Medicare, or accept assignment for my claims?
  3. Will you accept assignment for every rental month and every resupply order?
  4. Which brands and models do you supply? (Contract suppliers must offer the same range to Medicare and non-Medicare customers, per CMS.)
  5. Who handles repairs and replacements?

Verdict

Assignment is the simplest protection against surprise DME bills. Ask the five questions above, get the answers in writing, and pair an assignment supplier with Medigap if you want your 20% covered too (Medigap and DME).

Related: Medicare CPAP rules, Medicare oxygen coverage, switching oxygen suppliers, competitive bidding explained.

See also: reading your Medicare Summary Notice and ABN explained.

Frequently asked questions

What does it mean when a DME supplier accepts assignment?
It agrees to accept the Medicare-approved amount as full payment. Medicare.gov says it can then charge you only the Part B deductible and coinsurance, must submit the claim to Medicare and can't charge you for submitting it.
Can a DME supplier charge me more than the Medicare-approved amount?
If it doesn't accept assignment, yes. CMS says non-participating DME suppliers in non-bidding areas aren't required to accept assignment and can charge any amount. Medicare.gov's 15% limiting charge applies in many cases to non-participating health care providers.
What's the difference between participating and accepting assignment?
Medicare.gov says a supplier that participates in Medicare must accept assignment. A non-participating supplier may still accept assignment case by case.
What happens if a supplier won't accept assignment for my rental?
Medicare.gov says you may have to pay the full cost up front, and Medicare will pay you later for its share once your claims are processed.
Do competitive bidding contract suppliers accept assignment?
Yes. CMS says contract suppliers must submit claims for competitively bid items on an assignment basis.

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