MUE Units Adjudication (MAI 1/2/3)
Medically Unlikely Edit check: units billed vs the MUE value under the MAI (1 line-edit, 2 date-of-service absolute, 3 per-visit), giving payable units and whether the excess is rescuable.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Units billed
- 4
- MUE value
- 1
- MUE Adjudication Indicator
- 2
Result: MAI 2 is absolute: 1 unit payable, 3 at risk -- the excess can never be paid and must not be appealed as a units error.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Units billed
- MUE value (the ceiling)
- MUE Adjudication Indicator (1, 2, or 3)
- Units split across multiple lines
How this is calculated
CMS Medically Unlikely Edits (MUE) program. MUE Adjudication Indicator (MAI): 1 = claim-line edit; 2 = date-of-service edit, absolute (never payable); 3 = date-of-service edit, reviewable with documentation. No MUE table ships -- the value and MAI are entered. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
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