Medicare NCCI Medically Unlikely Edits


Medicare NCCI Medically Unlikely Edits (MUEs)

National Correct Coding Initiative (NCCI) Medically Unlikely Edits (MUEs) are used by the Medicare Administrative Contractors (MACs), to reduce improper payments for Part B claims. An MUE is the maximum units of service (UOS) reported for a HCPCS/CPT code on the vast majority of appropriately reported claims by the same provider/supplier for the same beneficiary on the same date of service. Not all HCPCS/CPT codes have an MUE.  

Although CMS publishes most MUE values on its website, other MUE values are confidential. Confidential MUE values are not releasable. The confidential status of MUEs is subject to change.  

Quarterly Version Update Changes

CMS posts changes to each of its NCCI MUE published edit files on a quarterly basis. This includes additions, deletions, and revisions to published MUEs for Practitioner Services, Outpatient Hospital Services, and DME Supplier Services.

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Page Last Modified:
06/03/2024 06:45 AM