The Centers for Medicare and Medicaid Services (CMS) published the 2025 Q3 updates to the NCCI edit files, effective July 1, 2025, replacing the 2025 Q2 versions.

Changes were made to the Medically Unlikely Edits (MUEs) for DME Supplier Services, Outpatient Hospital Services, and Practitioner Services MUE Tables including the addition, deletion, and revision of files. In addition, updates were made to Hospital and Practitioner Procedure-To-Procedure (PTP) Edits as well as the Add-On Code files.

As many states utilize MUE edit files for billing adjudication in their fee schedules, keeping track of relevant updates ensures that workers’ comp program remain in compliance with state laws. Additionally, MUEs help identify and prevent inappropriate payments by flagging claims that report unusually high volumes of services.