tci Medicare Compliance & Reimbursement - 2014 Issue 16

What Are MUEs?

Although CCI may be very familiar to you, any practice filing a claim with Medicare should also know what MUEs are and how they work. “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,” CMS says. “All HCPCS/CPT® codes do not have an MUE.” The MUE list includes specific CPT® or HCPCS codes, followed by the number of units that CMS will pay. CMS developed the MUEs to reduce paid claims error rates in...

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