TL;DR: What is CMS Changing?
CMS is resuming the DMEPOS Competitive Bidding Program (CBP).
Under the 2026 Final Rule, the next bidding round timeline has been set.
CMS began pre-bidding awareness in late 2025; specific registration and bidding windows are expected in late summer/early fall 2026.
CMS plans to include new product categories in this round, including:
- Class II continuous glucose monitors (CGMs) and insulin pumps.
- Urological supplies, ostomy supplies, hydrophilic urinary catheters
- Off-the-shelf (OTS) orthotic devices: back braces, knee braces, upper-extremity braces.
Additionally, CMS plans to change accreditation and oversight: suppliers will need annual reaccreditation (rather than every three years), and CMS will increase its oversight of accrediting organizations.
What Could This Mean for DMES?
- Reimbursement pressure/ lower margins: With competitive bidding driving down reimbursement rates (single payment amounts likely lower than current fee schedule), DME suppliers may see thinner margins on bid-items.
- Increased competition & consolidation risk: Smaller or mid-sized suppliers may struggle to compete on price - some may even opt out or go out of business. Industry groups have warned this could be devastating for smaller community-based providers.
- Operational and compliance burden: More frequent accreditation (annual), increased oversight, and stricter supplier enrollment and documentation requirements may raise supplier administrative burden.
- Product mix shift/ unpredictability: With new categories (e.g. CGMs, ostomy, orthotics) added to this round of bidding, suppliers may need to decide whether to bid on these or continue servicing existing (non-bid or legacy) categories.
- Business risk vs. opportunity: For some DMEs - especially large suppliers - this could be an opportunity to win contracts for high-volume items; but for others, especially small or niche DME providers, this represents a substantial risk to viability (see more on this point below).
What Has the Response Been?
Advocacy and med-tech industry voices (such as AdvaMed) argue that expanding competitive bidding to items like CGMs, ostomy and urological supplies, often individualized and clinically sensitive, may compromise patient care, reduce treatment options, and stifle innovation.
Plus, there is concern that because the bidding process emphasizes price, it may encourage suppliers to offer lower-cost, lower-quality products, again potentially affecting patient outcomes.
Unfortunately, small suppliers may bear the brunt of the bidding changes. The tricky combination of lower rates, tougher compliance requirements, and growing competition may force many out, reducing diversity of suppliers and potentially reducing local access for patients, especially in rural or underserved areas.
Details Are Still Unfolding: Here’s What You Need to Watch
Though the impact of CMS DMEPOS CBP may sound intimidating - and understandably so - it’s important to remember that, while CMS has finalized the seven product categories, specific HCPCS codes within each category and lead item designations will be announced in late spring/ early summer 2026.
While the proposal lists certain categories (braces, CGMs, ostomy etc.), actual items subject to bidding might be a narrower subset.
Plus, it’s unclear exactly how low reimbursement rates will go once bids are adjudicated, making the the margin pressure or cost-savings unpredictable at this time.
Additionally, the impact will likely vary widely by region (depending on competitive bidding area designation), size and type of supplier, and product mix (commodity vs specialized/customized DME).
What Does CMS Competitive Bidding Mean for Me, Right Now?
- If you’re a DME business owner (or considering starting one), we recommend paying attention to when CMS publishes the 2026 bid-item list and CBA definitions. Why? The bid-item list will determine whether your products are subject to bidding. For reference, here is the current master list.
- Prepare as needed for increased administrative load: ensure licensing/accreditation, compliance, documentation, and (potentially) higher scrutiny. In addition, consider diversifying product offerings! For example, consider offering products less likely to be commoditized via competitive bidding.
- Finally, workflow efficiency is critical! Perhaps more so than ever before. Identifying and implementing high-impact automation opportunities is key. Need a place to start? Get in touch! We look forward to having a conversation.
