On April 11th, the Centers for Medicare & Medicaid Services (CMS) released updated replacement files for Q2 of 2025 related to its NCCI Medically Unlikely Edits (MUEs) for Durable Medical Equipment (DME), Facility Outpatient Hospital and Practitioner Services.

According to CMS, the update includes a revised MUE value for HCPCS code J1628, retroactive to October 1, 2024.

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.