Guides / POD
POD Proof of delivery — every DMEPOS claimMedicare DME proof of delivery requirements
Citations verified against the CMS Medicare Coverage Database · Reviewed September 2026
Proof of delivery (POD) is the record showing that the beneficiary actually received the item Medicare is being billed for. It is one of the supplier standards in 42 CFR 424.57, it is spelled out in the Program Integrity Manual and the DME MACs' Standard Documentation Requirements article, and it is the one piece of the file that cannot exist at prior authorization time — which is why it is so often the piece that is missing when an Additional Documentation Request (ADR) arrives.
This guide covers the three recognized delivery methods, what the record must contain for each, how the date of service is set, the retention rule, and what happens when POD cannot be produced.
The requirements, with citations
The elements below are drawn from the cited CMS and DME MAC sources, not from AffirmDME's rules engine.
Method 1 — direct delivery to the beneficiary or designee
The POD is a signed and dated delivery document showing the beneficiary's name, the delivery address, a description of the item(s), the quantity delivered, the date delivered, and the beneficiary's or designee's signature. The date of service is the date the beneficiary received the item. A designee is anyone who can accept delivery on the beneficiary's behalf — except the supplier, its employees, or anyone else with a financial interest in the delivery.
Article A55426; PIM ch. 4 §4.7.3.1.1Method 2 — shipping or delivery service
Acceptable POD pairs the supplier's own detailed shipping invoice with the delivery service's tracking information. Together they must show the beneficiary's name, delivery address, a package identification or invoice number linking the supplier record to the carrier record, the item description, quantity, date delivered, and evidence of delivery. The supplier may use either the shipping date or the delivery date as the date of service, as long as the practice is consistent.
Article A55426; Noridian — Proof of DeliveryMethod 3 — delivery to a nursing facility on the beneficiary's behalf
The file needs documentation showing the supplier or its carrier delivered the item(s) to the facility, plus documentation from the facility demonstrating receipt and/or the beneficiary's use of the item. The quantities delivered and documented have to justify the amounts billed.
Article A55426 — Proof of DeliveryEarly delivery ahead of discharge: bill the discharge date
A supplier may deliver DME, a prosthetic, or an orthotic — not supplies — up to two days before a beneficiary's anticipated discharge from an inpatient facility, either to the facility for fitting and training or to the home in anticipation of discharge. In both cases the claim's date of service is the discharge date, and nothing may be billed for days before it.
PIM ch. 4 §4.7.3.1.2Retain POD for seven years from the date of service
Proof of delivery and claims documentation must be kept in the supplier's files for seven years starting from the date of service and produced within the requested timeframe when a contractor asks. Retention failures are treated the same as never having had the record.
PIM ch. 4 §4.7.3.1; Article A55426What usually sinks these claims
- The delivery ticket is signed by a supplier employee as the beneficiary's designee
- A shipped item is billed with a date of service that matches neither the ship date nor the delivery date
- A facility delivery has the supplier's ticket but nothing from the facility showing receipt or use
- The ticket says “equipment” with no quantity or a description that cannot be matched to the HCPCS billed
- An item delivered in anticipation of discharge is billed with the actual delivery date instead of the discharge date
POD is on the checklist, not an afterthought
AffirmDME reads delivery tickets and carrier records the way it reads chart notes, and flags a missing signature, date, or quantity on the readiness checklist — while the delivery is still recent enough to fix.
See the readiness checklistFAQ
Does proof of delivery need the beneficiary's signature?
For direct delivery, yes — the beneficiary or a qualifying designee signs and the document is dated. For items sent by a shipping service, the carrier's tracking information plus the supplier's detailed shipping invoice serve as POD instead. Delivery to a nursing facility relies on the facility's documentation of receipt or use.
What date of service do I use for a shipped item?
Either the shipping date or the delivery date. CMS defines the shipping date as the date the carrier label is created or the date the item is retrieved for delivery, and expects the supplier's choice not to vary significantly from claim to claim.
How long do I have to keep POD records?
Seven years from the date of service, for both POD and the rest of the claims documentation. Contractors can request it at any point in that window, and the Program Integrity Manual says items without POD are denied and overpayments recovered.
Does AffirmDME check proof of delivery?
Yes. Upload the delivery ticket or carrier record and AffirmDME's document extraction reads it; the readiness checklist shows POD as an item on every case, and missing-document detection flags a ticket without a signature, date, or quantity so it is fixed while the delivery is still recent.
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This guide summarizes Medicare requirements as implemented in AffirmDME's compliance engine, with citations to the governing sources. It is not legal or billing advice; LCDs and CMS policy change — always confirm against the current policy text linked above.
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Unfamiliar term? The glossary defines ADR, SWO, UTN, PTAN and the rest; the PA List lookup checks any HCPCS code.