CMS MUE Resources

CMS originally developed the Medically Unlikely Edit (MUE) program to reduce the paid claims error rate for Part B claims. The first edits were implemented January 1, 2007. Subsequently there have been quarterly updates increasing the number of edits. In 2008, CMS has been refining the edits based on 100% submitted claims data from a six month period in 2006. For a complete overview, visit the MUE Main page at CMS website.

Beginning October 1, 2008, coincident with implementation of MUE version 2.3, CMS published the majority of existing MUEs on the CMS website accessed through the MUE webpage HERE.

Find CMS's MUE FAQs HERE. (12 answers available)

FREE Downloads from CMS

Practitioner/DME Supplier MUE Table - Updated 4/1/09 (ZIPPED Excel file, 127 KB)

Hospital Outpatient Services MUE Table - Updated 4/1/09 (ZIPPED Excel file, 92 KB)

CMS Contact

If you have concerns about the MUE program other than MUE values for specific codes, CMS asks you to contact Valeria Allen ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

Team eduTrax has pulled out the most useful links for providers below:

Medicare Claim Review Programs Booklet on MR, NCCI Edits, MUEs, CERT, and RAC (PDF, 14 pgs, 1.73 MB)

MLN Matters Number: MM5402 - Medically Unlikely Edits (MUEs) Announcement, January 2, 2007 (PDF, 2 pgs, 78 KB)

Letter Announcing Publication of MUEs, dated September 18, 2008 (PDF, 2 pgs, 51 KB)

Transmittal 1386: Quarterly Update to CCI Edits, Version 14.0, Effective 01/01/2008 (PDF, 5 pgs, 154 KB)

MLN Matters Number: MM5824 - Qtrly Update, v14.0, Effective 01/01/2008 (PDF, 2 pgs, 72 KB)

NCCI Policy Manual for Medicare Services - Updated 4/9/09 (PDF as ZIP file, 444 KB)

Medicare Claims Processing Manual, Chapter 23, Sec. 20.9 (PDF, 259 pgs, 1.29 MB)

Modifier 59 Article by CMS: Proper Usage Regarding Distinct Procedural Service (PDF, 5 pgs, 20 KB)

Transmittal 617: Change Request 5402, dated December 8, 2006, is being rescinded and replaced with this (PDF, 14 pgs)

CMS NCCI FAQ (61 answers available, as of 2/26/10)

NTIS is CMS's authorized distributor of CCI codes

Visit their website: National Technical Information Service (NTIS)

To Order NTIS Products: NCCI Order Form from NTIS

Below are links to their product information pages:

Please note: eduTrax^® does NOT sell these products.