Medicare Durable Medical Equipment (DME) Appeals

Filing a Medicare DME Appeal

You may file a reconsideration request with Maximus if your claim for Medicare DME items or services was denied. Your reconsideration request will be handled by Maximus. The DME QIC jurisdiction encompasses all states.

After a DME Medicare Administrative Contractor (MAC) has made a redetermination (first level appeal) for Medicare items or services, a reconsideration (second level appeal request) may be filed as follows:

How to File An Appeal

The request must be filed with Maximus and can be submitted via the following methods:

  • QIC Appeals Portal at https://qicappeals.cms.gov (opens in new tab)
  • In writing to the Maximus address indicated on the notice of redetermination. Part B DME standard reconsideration requests should be mailed to: Maximus DME QIC 3750 Monroe Ave Suite 777 Pittsford, NY 14534-1302
  • Via secure fax to 585-869-3314

The request must be in writing. The request should be submitted via a standard CMS form (opens in new tab), or alternatively, the request must contain:

  • The beneficiary’s name
  • Medicare Beneficiary Identifier or Medicare health insurance claim number
  • The specific service(s) and item(s) for which the reconsideration is requested and the specific date(s) of service
  • The name of the party or the representative/billing agency (opens in new tab) of the party
  • The name of the contractor that made the redetermination

QIC Appeals Portal (opens in new tab)

Reconsideration Request Form (opens in new tab)

For the status of your appeal, please use the appeal status lookup tool: Q2 Administrators > Home (opens in new tab)

Request a Duplicate Copy of a Decision Letter

If you’d like to request a copy of a decision letter, please click Copy of Decision | Medicare Appeals to submit a request. For additional information on this process click Decision Letter Help | Medicare Appeals.

Key Contacts

If you have question or concerns regarding the Part B DME Qualified Independent Contractor (QIC), please contact DMEInfo@maximus.com.

Suppliers can reach us at 585-348-3200.

Beneficiaries may also direct their questions to the Medicare Service Center at 1-800-MEDICARE or 1-800-633-4227.

For information about the availability of auxiliary aids and services, please visit: https://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html (opens in new tab)

Submitting Personal or Confidential Information

Any document that contains the identity of a beneficiary or a provider is confidential. For this reason, Maximus cannot accept confidential information sent via email transmission. Submit confidential information to Maximus in hard copy by US mail, commercial delivery service or via secure fax to 585-869-3314.

Sending an Email

Electronic mail is not necessarily secure against interception. If your communication is very sensitive or includes personal information, please send it by postal mail or fax (585-869-3314) instead. If you still wish to email us, please send to DMEInfo@maximus.com.

Please note: All activities related to the DME QIC Telephone Discussion and Reopening Process Demonstration have ended as of December 31, 2021. If you have questions regarding your appeal, you may submit your inquiry by:

Fax at 585-869-3314
E-mail at dmeinfo@maximus.com
Phone by calling 585-348-3200