DenialMUE Lookup
Look up the CMS Medically Unlikely Edit limit for any CPT or HCPCS code. Shows the maximum billable units per day and the MAI adjudication indicator that determines whether the limit is absolute or appealable.
Common codes
About MUE Adjudication Indicators
MAI 1 — Claim Line
Units reviewed per claim line. May be overridden in some circumstances with adequate documentation or by splitting across claim lines per payer policy.
MAI 2 — Date of Service
Absolute maximum units across all claim lines for a single date of service. Cannot be overridden by modifier, documentation, or medical review appeal.
MAI 3 — Clinical Policy
Absolute limit set by clinical policy per date of service. The strictest category — no override path exists under any circumstance.
MUE values are published quarterly by CMS as part of the NCCI edits. Limits apply to Medicare Part B claims. Commercial payers may apply different limits.