Medicare Assignment for Medical Equipment, Explained

What it means when a medical equipment supplier accepts Medicare assignment, what you pay, and how Medicare's rent-or-buy rules work.

When you shop for a wheelchair, CPAP machine, oxygen or other medical equipment, one detail on a supplier listing matters a lot: whether the supplier accepts Medicare assignment. This guide explains what that means, what you can expect to pay under Original Medicare, and how Medicare decides whether you rent or buy an item. It is general information, not medical or legal advice.

What "accepts assignment" means

Medicare Part B covers durable medical equipment (DME) when your doctor or another treating provider prescribes it for use in your home. According to Medicare's guide to DME coverage, assignment means the supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered items. A supplier that accepts assignment:

• Can charge you only the Part B deductible and coinsurance for the Medicare-approved amount.
• Usually waits for Medicare to pay its share before asking you to pay yours.
• Must submit the claim directly to Medicare and cannot charge you for submitting it.

Medicare also only pays for DME that comes from a supplier enrolled in Medicare, meaning the supplier has been approved and has a Medicare supplier number. If a store or company is not enrolled, Medicare will not pay the claim, even if the business is large and well known.

Participating vs. non-participating suppliers

A participating supplier has agreed to accept assignment for all Medicare-covered items. As Medicare.gov explains, if a supplier participates in Medicare, it must accept assignment.

A non-participating supplier has not agreed to accept assignment for everything, but it can still choose to accept assignment one claim at a time. If it does not accept assignment for your item, you may be charged more than the Medicare-approved amount, and you might have to pay the full amount at the time of service and wait for Medicare to reimburse its share. Even then, the supplier should still submit a claim to Medicare for covered items and cannot charge you for doing so.

What you pay under Original Medicare

For most covered equipment, you pay 20% of the Medicare-approved amount after you meet your yearly Part B deductible, and Medicare pays the other 80%. The Medicare-approved amount is the lower of the supplier's actual charge or the fee Medicare sets for the item. For 2026, CMS set the Part B deductible at $283.

A few points to keep in mind:

• A Medigap (Medicare Supplement) policy may help cover some of your share.
• If you are in a Medicare Advantage Plan, the plan must cover the same categories of medically necessary DME, but your suppliers and costs depend on your plan. Check your plan's "Evidence of Coverage" or call the plan.
• If you are in a skilled nursing facility for a Part A-covered stay, the facility is responsible for providing the DME you need there.

Rent or buy: how Medicare pays for equipment

Medicare pays for most DME on a rental basis. The Medicare booklet describes several payment categories:

• Inexpensive or routinely purchased items, such as canes, walkers and blood sugar monitors, can be bought. If you rent one instead, total rental payments are limited to the fee Medicare sets to buy it.
• Capped rental items, such as many wheelchairs and hospital beds, are rented for up to 13 months of continuous use. Under the federal rule at 42 CFR 414.229, the supplier must transfer ownership to you on the first day after the 13th continuous rental month.
• Oxygen equipment follows its own rules: rental payments stop after 36 months, but the supplier must keep furnishing equipment for up to 5 years while you need it.
• Frequently serviced items, such as ventilators, are paid monthly for as long as they are medically necessary.

While you rent, the supplier is responsible for maintenance, repairs and replacement parts, and must pick up equipment that needs repair. Once you own an item, Medicare may pay 80% of the approved amount for repairs (up to the cost of replacing the item), and you pay the other 20%. The supplier that sold you the item is not required to repair it, so you may need to find another enrolled supplier for service. Owned equipment may be replaced if it is lost, stolen, damaged beyond repair, or used past its reasonable useful lifetime, which is generally 5 years from the date you start using it.

What to do if a supplier doesn't accept assignment

1. Confirm enrollment first. Ask whether the supplier is enrolled in Medicare and has a supplier number.
2. Ask whether they will accept assignment in your case. Non-participating suppliers can agree on a claim-by-claim basis.
3. Ask for the non-assignment charge in writing before you agree to anything, so you can compare it with your 20% share at a supplier that accepts assignment.
4. Ask whether they will bill Medicare for you and whether you must pay up front.
5. Look for another supplier. You can search Medicare's medical equipment supplier finder or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

A note on competitive bidding

In some past rounds of Medicare's competitive bidding program, people in certain areas generally had to use a contract supplier for specific items. According to CMS, the program has been in a temporary gap period since January 1, 2024, and during the gap you can get items from any Medicare-enrolled supplier. CMS has said the next round is planned for 2028, so check the program page or ask a supplier if you see a contract status listed.

Keep records and speak up

Keep copies of your orders, delivery receipts and Medicare Summary Notices, and compare what you were billed with what you received. If you have a problem with a supplier, you can contact the supplier or file a DME complaint through 1-800-MEDICARE.

Updated 2026-09-30.