Competitive Bidding Round 2028: What DME Suppliers Actually Need to Know

Round 2028 of the DMEPOS Competitive Bidding Program doesn’t work like the rounds before it. Most of it runs as a single Nationwide Remote Item Delivery model: a handful of suppliers per category win the right to furnish an item by mail across the entire country, not just in certain metro areas. If you supply one of seven specific product categories, whether you keep billing Medicare for that item nationally after January 1, 2028 depends on whether you win a contract in this round. Suppliers who don’t win a contract generally lose the ability to bill Medicare fee-for-service for that category once new payment rates take effect, subject to a limited set of exceptions.

What Round 2028 actually is

CMS finalized Round 2028 in its CY2026 Home Health Prospective Payment System Final Rule, and the Competitive Bidding Implementation Contractor (CBIC) administers the day-to-day bidder education, registration, and pricing guidance on its website. Earlier competitive bidding rounds split the country into regional Competitive Bidding Areas, and suppliers bid to serve a specific metro area or region. Round 2028 moves most product categories into a Nationwide Remote Item Delivery (RID) structure instead: CMS awards a small number of contracts per category, and those contract suppliers (often called Medicare contract suppliers) furnish the item nationwide, primarily through mail order and direct shipment rather than local delivery.

That’s a structural shift, not just a new set of items. Under the RID model, there’s no “your area wasn’t included” outcome the way there sometimes was under the old regional system. If your product category is in Round 2028, the competition is national, and so is the exposure.

The seven categories actually affected

Round 2028 covers these categories, and nothing outside this list is part of this round:

Lead item codes and bid limits are from CBIC’s Phase 1 Bid Preparation release (June 2026). Each category also includes non-lead HCPCS codes priced off the lead item’s single payment amount — confirm the full list on CBIC’s website before billing.

What’s notably not included

CMS updated its own fact sheet specifically to clarify this, which tells you it was a common point of confusion: legacy categories from earlier competitive bidding rounds are not part of Round 2028.

If your business supplies these categories and nothing on the affected list above, Round 2028 doesn’t put your Medicare billing for those items at risk. If you supply both, only the affected lines are exposed.

Does this apply to Medicare Advantage?

No. Round 2028, like the rest of the DMEPOS Competitive Bidding Program, governs Medicare fee-for-service (Original Medicare) only. CMS has stated that its competitive bidding program applies to people with Original Medicare, not people enrolled in Medicare Advantage plans. Medicare Advantage plans are not required to use CBP contract suppliers; they typically negotiate their own supplier networks, coverage terms, and payment rates independently.

In practice, this means a Round 2028 outcome affects a supplier’s ability to bill Medicare FFS for a given category, but does not by itself change any existing Medicare Advantage contracts, network agreements, or commercial payer relationships that supplier holds. Suppliers with a mixed payer base should evaluate Round 2028 exposure against their Medicare FFS volume specifically, not their total book of business.

The timeline, and where CMS’s own pages disagree

CMS’s original fact sheets, going back to late 2025, put bidder registration and the bid window opening at late summer/early fall 2026. CMS’s current competitive bidding site now lists that same step as late fall 2026 instead. That’s a real shift from CMS’s own source, and most secondary coverage is still repeating the older late summer/early fall 2026 language.

What bidding actually requires

Round 2028 tightened the financial and documentation bar for bidders compared to earlier rounds. Before registration opens, it’s worth understanding what a bid actually commits you to.

What this means for your business

*Reflects Medicare fee-for-service billing for the affected category only. Commercial insurance, Medicare Advantage, and other revenue streams are not directly governed by Round 2028.

Should you bid? A quick decision guide

Why this isn’t optional

Competitive bidding contracts aren’t a pricing negotiation you can decline and still participate in on the old fee schedule. Once contracts take effect for a category, generally only the winning contract suppliers can bill Medicare fee-for-service for that item nationally. A supplier in one of the seven affected categories that doesn’t submit a bid, or bids and doesn’t win, generally cannot bill Medicare fee-for-service for that item nationally after that date, subject to a limited set of exceptions.

The six-month transition period built into the timeline exists because CMS knows this is disruptive for beneficiaries who need to switch suppliers. It is not a grace period that lets a non-contract supplier keep billing as before.

Accreditation, enrollment, and operational readiness

Winning a bid isn’t the only requirement. CMS and CBIC guidance also expects bidders to have their underlying compliance readiness in order before the bid window opens, and gaps here can disqualify an otherwise strong bid.

• Accreditation status. All locations included in a bid must hold current accreditation from a CMS-approved accrediting organization. If any location isn’t accredited yet, start now, since accreditation can take months. See our accreditation preparation service.
• Medicare enrollment and PTAN status. Every location on a bid needs an active Medicare enrollment record (CMS-855S) and a corresponding PTAN. If you’re not yet Medicare-enrolled, don’t assume enrollment can be completed on short notice; DMEPOS applications can take weeks to months. See our Medicare enrollment support.
• State and territory licensure. All locations on a bid must collectively hold current, non-expired state and territory licenses for the categories bid on, verified in PECOS by the close of the bid window.
• Operational capacity for nationwide fulfillment. The RID model means furnishing items by mail or direct shipment nationwide, not regionally. Confirm your logistics and supply chain can support national volume before bidding, not after winning.
• Confirm whether you’re actually affected. Check your product lines against the seven-category list above, not against “competitive bidding” as a general concept.
• Don’t rely on a single source for the registration date. Given the discrepancy between CMS’s own pages, check the CBIC website directly close to the date rather than a fact sheet that may be a year old.
• Review your financial documentation readiness now. Recent rule changes reduced some financial submission requirements, generally now a business credit report with a numerical score or rating, but bidder registration still requires organized business documentation.
• Understand your exposure if you don’t win. If your business depends significantly on one of these seven categories for Medicare FFS revenue, this is a business continuity question, not just a billing question.

Frequently Asked Questions