ACHC vs. BOC vs. The Compliance Team — DMEPOS Accreditor Comparison

Last updated: October 2026

ACHC, The Compliance Team (TCT) and BOC are three accreditors that traditional HME/DME suppliers use, and each fits a different supplier profile. In December 2025 BOC sued HHS, CMS and the HHS Secretary in federal court, seeking review of agency action and asking for a temporary restraining order (Board of Certification/Accreditation International, Inc. v. Kennedy, No. 1:25-cv-04150 (D. Md.), docket, page opened October 4, 2026). The public docket we reviewed does not show the case's current status. Check CMS's current list of approved DMEPOS accrediting organizations and BOC's status in your state before you choose BOC.

IHS has no financial relationship with any accrediting organization. This comparison is built entirely on regulatory facts and client outcomes.

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Why Accreditor Selection Matters More in 2026 Than Ever Before

Before 2026, most DMEPOS suppliers chose an accrediting organization once every three years and rarely revisited the decision. The January 1, 2026 annual survey mandate and the BOC litigation have changed that calculus. Accreditor selection is now a strategic operational decision — one that affects your annual compliance cost, documentation infrastructure, state-by-state risk exposure, and ability to operate without interruption if regulatory status changes mid-cycle.

Nine accrediting organizations hold CMS approval as of early 2026. This comparison focuses on three accreditors that traditional HME/DME suppliers use: ACHC, The Compliance Team (TCT), and BOC. NABP, ABC, CHAP, TJC, HQAA, and DNV Healthcare are each appropriate for specific supplier profiles discussed below.

Side-by-Side Comparison: ACHC vs. TCT vs. BOC

Criteria	ACHC	The Compliance Team (TCT)	BOC
CMS Approval Status (2026)	Approved — full national coverage	Approved — full national coverage	Federal lawsuit filed December 2025 (Board of Certification/Accreditation International, Inc. v. Kennedy, No. 1:25-cv-04150 (D. Md.), docket, page opened October 4, 2026). Check current CMS status
Standards Last Updated	August 29, 2025 — major update integrating 2026 annual survey mandates; language shift to patient-centered care	Continuous real-time web-based portal updates; 2026 F2F documentation standards enforced	Ask BOC for its current standards
Survey Frequency (2026)	Annually (minimum every 12 months per CMS mandate)	Annually (minimum every 12 months per CMS mandate)	Annually — same CMS mandate
Product Category Breadth	Broadest — covers all HME/DME, respiratory, O&P, pharmacy DMEPOS, enteral nutrition, complex rehab	Broad — strong across traditional DME and pharmacy-based DMEPOS	Strong in O&P and orthotics; also covers general DME; narrower than ACHC for complex rehab and respiratory
State Availability	All 50 states	All 50 states	Check BOC's current CMS status in your state
Survey Methodology	Unannounced on-site; tracer methodology; warehouse and patient file review	Unannounced on-site; documentation-heavy; real-time portal enables continuous surveyor access to records	Unannounced on-site; historically strong in O&P facility evaluation
Documentation Platform	Paper/PDF-based submissions; no proprietary portal	Real-time web-based compliance portal — enables continuous documentation updates and preparation for annual surveys	Standard submission; no proprietary portal equivalent to TCT
Survey Fees (Base, 2026)	Custom quote — contact ACHC directly for current pricing	Custom quote — contact TCT directly for current pricing	Custom quote — contact BOC directly for current pricing
Published Fee Schedule?	No — custom quotes only	No — custom quotes only	No — custom quotes only
Top Cited Deficiencies	Equipment Cleaning & Storage (DRX7-12D); Sanitary Environment	Leadership Policy Review (ADM 1.0); Ongoing HR Training (HR 1.0)	DATA_GAP — BOC does not publicly publish deficiency data
M&A / Transition Risk	Ask ACHC about transition timing	Ask TCT about transition timing	Depends on BOC's federal lawsuit and CMS's decisions
Pharmacy-Based DMEPOS	Yes — ACHC pharmacy division covers DMEPOS billing; separate tracks for pharmacy and DME	Yes — covers pharmacy with DMEPOS billing	Not the primary choice for pharmacy-based DMEPOS
Best For	Suppliers whose product categories and states fall within ACHC's DMEPOS program	Suppliers prioritizing documentation infrastructure and annual survey readiness systems	Existing BOC clients who have checked BOC's current CMS status in their state

Other CMS-Approved Accrediting Organizations — When They Apply

ABC (American Board for Certification in O&P/Pedorthics)

ABC accredits Orthotics and Prosthetics (O&P) clinics and pedorthists. It publishes its 2026 fee schedule (ABC fee schedule): first-time primary location $1,855 (includes application and on-site survey), affiliate locations $965 each (maximum of 4), annual maintenance $630 primary / $315 affiliate, renewal $1,225 for a primary location.

NABP (National Association of Boards of Pharmacy)

NABP is the most efficient path for pharmacies billing Medicare for DMEPOS-covered items (diabetic testing supplies, enteral nutrition, OTS orthotics). NABP's accreditation covers both pharmacy operations and certain DMEPOS billing categories in a single credential — eliminating the dual-track requirement of ACHC pharmacy division. Best for: pharmacies with limited DMEPOS billing volume that want to minimize administrative burden.

CHAP (Community Health Accreditation Program)

CHAP is well-suited for home-based care organizations that also supply DMEPOS items — particularly respiratory therapy and home infusion crossover scenarios. CHAP published several of the 2025/2026 deficiency reports used in this comparison (TB Control Plans, Safety Program Documentation, Patient Equipment Training, Respiratory Setup Guidelines).

TJC (The Joint Commission), HQAA, DNV Healthcare

TJC is typically chosen by hospital-affiliated DMEPOS operations seeking consistency with their hospital accreditation body. HQAA specializes in HME/DME with a focus on smaller independent suppliers. DNV Healthcare serves organizations already in the DNV ecosystem. IHS works with all three and selects based on your organizational profile.

When to Choose ACHC

Situations that commonly lead suppliers to evaluate ACHC:

Suppliers whose state or payer terms narrow their choice — check which accreditors CMS currently approves and your payers accept
Suppliers transitioning from BOC — IHS prepares the documentation and transition plan for BOC-to-ACHC transitions, which your organization carries out with ACHC
Multi-category operators — ACHC's standards breadth covers respiratory, complex rehab, enteral nutrition, pharmacy-based DMEPOS, and traditional HME in a single accreditation
Organizations with a near-term accreditation deadline — ask ACHC about its survey timeline for your product categories
New market entrants — ACHC's 2025/2026 standards update is well-documented and widely understood by compliance professionals

Key ACHC facts: Standards updated August 29, 2025; language shifted from "cultural diversity" to "patient-specific needs/patient-centered care." The Equipment Cleaning and Storage standard (DRX7-12D) is cited in 30% of ACHC surveys — IHS specifically targets this in mock surveys. ACHC uses custom quoting — contact ACHC directly for current survey fees.

When to Choose The Compliance Team (TCT)

TCT may fit a supplier for which the 2026 annual survey mandate is the main operational challenge:

Organizations building continuous compliance infrastructure — TCT's real-time web-based portal turns ongoing documentation into a managed system rather than a periodic project
Suppliers who have repeatedly struggled with HR training documentation — TCT's HR 1.0 standard is a top deficiency citation; its portal facilitates the exact annual training logs TCT surveys look for
Organizations with distributed or remote compliance management — the web portal enables documentation access and updates without physical file management
Suppliers seeking the operational efficiency of digital-native compliance — TCT's model is built for continuous readiness, not for periodic sprint-and-rest preparation cycles

Key TCT facts: Continuous real-time portal updates enforcing 2026 F2F documentation standards. Top cited deficiencies are Leadership Policy Review (ADM 1.0) and Ongoing HR Training (HR 1.0) — both directly addressable through the portal system.

Checking BOC's Status Before You Choose

Before staying with or choosing BOC, check these points:

Current status: Check CMS's current list of approved DMEPOS accrediting organizations and whether BOC's approval covers your state
Litigation: BOC's federal lawsuit (Board of Certification/Accreditation International, Inc. v. Kennedy, No. 1:25-cv-04150 (D. Md.), docket, page opened October 4, 2026) may change its status, so keep a contingency plan
Business continuity: If regulatory continuity is a material business risk given upcoming M&A activity, CBP bid submission, or multi-state expansion, weigh that risk before starting a new BOC accreditation

IHS prepares the documentation and transition plan for BOC-to-ACHC and BOC-to-TCT transitions as a dedicated engagement type, aimed at avoiding a billing interruption while your organization completes the accreditor transition itself.

Can You Use Multiple Accrediting Organizations?

A DMEPOS supplier location enrolls with CMS under one accrediting organization at a time — you cannot hold dual accreditation for the same physical location under the same Medicare billing number. However, multi-location organizations sometimes use different AOs across locations when product mix or state requirements make different AOs optimal for specific sites. Organizations with both DMEPOS and other service lines (home health, pharmacy, home infusion) may hold accreditation from different AOs for different service types.

IHS structures multi-AO engagements for complex organizations when warranted — for example, an organization using ACHC for its DME locations and NABP for its pharmacies billing DMEPOS codes. The key is ensuring the compliance infrastructure for each location maps to its specific AO's standards without cross-contaminating documentation requirements.

Why IHS for Accreditor Guidance

IHS is a specialized healthcare accreditation consulting firm founded in 2002 by Thomas G. Goddard, JD, PhD, former URAC COO and General Counsel.More importantly for accreditor selection: IHS has no financial relationship with any accrediting organization. When a consulting firm has a referral arrangement with a specific AO — common in this market — their "recommendation" is structurally compromised. IHS helps you weigh the factors that drive the choice, such as payer or contract language, product categories, state rules and survey timeline.

IHS also covers the intersection of accreditor selection with state-level licensing complexity. ACHC accreditation in Texas still requires a Device Distributor License through DSHS. The accreditor comparison does not exist in isolation from the 36-month rule, the enrollment moratorium, and the CBP 2028 bid window. IHS covers all of it in one engagement.

Frequently Asked Questions

Which other programs does ACHC offer besides DMEPOS?

ACHC's program menu names Ambulatory Care, Ambulatory Surgery Center, Assisted Living, Behavioral Health, Clinical Laboratory, Critical Access Hospital, Dentistry, Healthcare Staffing Services, Home Care, Home Health, Home Infusion Therapy, Hospice, Hospital, In-Home Hospital Care, Office-Based Surgery, Palliative Care, PCAB (Compounding Pharmacy), Pharmacy, Pharmacy Inspection Services, Renal Dialysis and Sleep alongside DMEPOS. It also lists Joint Replacement Certification, Lithotripsy Certification, Long-Term Care Dialysis Certification, Stroke Certification, Telehealth Certification and Wound Care Certification (ACHC, page opened October 4, 2026). ACHC's home page shows certification as its own category, and ACHC's FAQs call Healthcare Staffing Services a certification (ACHC, FAQs, page opened October 4, 2026), so check which label a payer or regulator asks for.

Can I currently get accredited through BOC in California, Florida, New York, or Texas?

Check CMS's current list of approved DMEPOS accrediting organizations and BOC's status in your state before you apply. In December 2025 BOC sued HHS, CMS and the HHS Secretary in federal court, seeking review of agency action and asking for a temporary restraining order (Board of Certification/Accreditation International, Inc. v. Kennedy, No. 1:25-cv-04150 (D. Md.), docket, page opened October 4, 2026). The public docket we reviewed does not show the case's current status. If BOC is not available in your state, which CMS-approved accrediting organization to use instead depends on the supplier's product categories, payer and contract requirements, and survey timeline.

What does The Compliance Team offer DMEPOS suppliers in 2026?

Ask TCT whether it offers a compliance portal and how often it surveys. Compare it with ACHC and BOC on survey cadence, product coverage and state availability.

Can I hold accreditation from more than one DMEPOS accrediting organization?

A DMEPOS location enrolls under one AO per Medicare billing number. Multi-location operators may use different AOs across sites when warranted by product mix or state requirements. IHS structures multi-AO engagements for complex organizations.

What is the difference between ACHC and NABP for pharmacy-based DMEPOS billing?

NABP covers both pharmacy and certain DMEPOS categories in a single credential — more efficient for pharmacies with limited DMEPOS volume. ACHC requires separate tracks but offers broader DMEPOS product coverage. Best choice depends on your billing mix and existing NABP status.

Does the accrediting organization affect Medicare reimbursement rates?

No — accreditor choice has no effect on Medicare reimbursement rates. Rates are set by CMS fee schedules and the Competitive Bidding Program. Accreditation is binary: accredited suppliers can bill; unaccredited suppliers cannot.

What should current BOC-accredited suppliers do given the ongoing litigation?

Check BOC's current CMS status in each state where you operate, follow BOC's federal case (Board of Certification/Accreditation International, Inc. v. Kennedy, No. 1:25-cv-04150 (D. Md.), docket, page opened October 4, 2026), and keep a contingency plan for moving to another CMS-approved accrediting organization. IHS prepares the documentation and transition plan for BOC-to-ACHC and BOC-to-TCT transitions as a dedicated engagement type, which your organization carries out with each accreditor.

Not Sure Which Accreditor Is Right for You?

IHS provides independent accreditor selection guidance as part of every DMEPOS engagement gap analysis. We assess your product categories, state exposure, M&A plans, and 2026 timeline before making any recommendation.

Contact IHS: info@integralhs.com | Contact page

Adjacent services: Home Health & Hospice Accreditation