- ABN Modifiers
- American Medical Association and Current Procedural Terminology
- CMS Forms and Publications
- CMS Regional Offices
- Clinical Lab Improvement Amendment
- Comprehensive Error Rate Testing
- Electronic Health Records
- Electronic Prescribing
- Evaluation and Management Documentation Guidelines
- Federal Register
- Health Insurance Portability and Accountability Act of 1996
- Interactive Voice Response System
- Limitation of Liability (Advance Beneficiary Notice of Noncoverage)
- Local Coverage Determination
- Medically Unlikely Edits
- Medicare Coverage Database
- Medicare Electronic Data Interchange
- Medicare Fraud and Abuse
- Medicare Learning Network®
- Medicare Provider-Supplier Enrollment with NGS
- NGS Internet Resources
- NGSConnex Online Web Application Can Save Time and Money
- NGS Check Provider Enrollment Application Status Tool
- National Correct Coding Initiative
- National Coverage Determination
- National ICD-10-CM-PCS: The Next Generation of Coding
- National Provider Calls and Events
- National Provider Identifier
- National Provider Identifier Registry
- National Uniform Claim Committee
- Open Door Forums
- P.O. Box Mailing Addresses
- Patient Protection and Affordable Care Act of 2010
- Physician Quality Payment Program
- Provider Contact Center
- Provider Enrollment
- Reconsideration (Second Level of Appeal)
- Recovery Audit Program
- Redetermination (First Level of Appeal)
- Skilled Nursing Facility Consolidated Billing
- U.S. Government Printing Office
- Washington Publishing Company
Medically Unlikely Edits
In January 2007, CMS developed MUEs to reduce the paid claims error rate for Part B claims. An MUE for a HCPCS /CPT code is the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service. All HCPCS/CPT codes do not have an MUE. The published MUE will consist of most of the codes with MUE values of 1‒3. CMS will update the MUE values on its website on a quarterly basis. Although CMS publishes most MUE values on its website, other MUE values are confidential and are for CMS and CMS Contractors' use only. The latter group of MUE values should not be released since CMS does not publish them.
You will find the latest version of the MUEs on the CMS web page, Medically Unlikely Edits.
Inquiries about the MUE program other than those related to MUE values for specific HCPCS/CPT codes should be sent to the email address NCCIPTPMUE@cms.hhs.gov.
Reviewed 10/18/2024