Medically Unlikely Edits Information on the CMS Website

Published 12/11/2024

The Centers for Medicare & Medicaid Services (CMS) developed Medically Unlikely Edits (MUEs) to reduce the paid claims error rate for Part B claims. Palmetto GBA has noticed a trend in providers submitting redetermination requests to the Appeals area requesting an appeal for a MUE denial.

Please review the CMS MUE website. If you have questions after reviewing the website, please contact the Provider Contact Center (PCC) prior to filing an appeal.

 

 


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