American Speech-Language-Hearing Association

Medically Unlikely Edits for Speech-Language Pathology Services

Medically Unlikely Edits (MUEs), a subset of the National Correct Coding Initiative (CCI), are used for Medicare Part B and Medicaid claims. An MUE for a CPT or HCPCS Level II (supplies, equipment, and, devices) code specifies the maximum number of times that the code can be reported for the same patient on the same day. There are separate MUEs for office and hospital outpatient settings, though the edits for speech-language pathology are similar in both settings. The following tables for speech-language pathology related MUEs are derived from the complete lists of edits published on the Centers for Medicare & Medicaid Services (CMS) MUE website. They list codes that have MUEs and the number of times each code may be billed for the same patient on the same day for both office and outpatient settings.

An exception may be requested for medically reasonable and necessary services that exceed the MUE limit by reporting certain modifiers, as outlined by CMS.

Note: Not all codes have an MUE.

Table 1: CPT Code MUEs for Speech-Language Pathology Services

CPT Code MUE Values
  Office Setting Hospital Outpatient Setting
31575 1 1
31579 1 1
70371 1 1
74230 1 1
76536 1 1
92507 1 1
92508 1 1
92511 1 1
92512 1 1
92520 1 1
92521 1 1
92522 1 1
92523 1 1
92524 1 1
92526 1 1
92605 0 N/A
92609 1 1
92610 1 1
92613 1 1
92615 1 N/A
92617 1 N/A
92618 0 N/A
92626 1 1
96105 3 3
96125 2 2

Table 2: HCPCS Code MUEs for Speech-Language Pathology

HCPCS Code MUE Values
  Office Setting Hospital Outpatient Setting
E1902 1 1
E2500 1 N/A
E2502 1 N/A
E2504 1 N/A
E2506 1 N/A
E2508 1 N/A
E2510 1 N/A
E2511 1 N/A
E2512 1 1
L8500 N/A 1
L8501 2 2
L8507 3 3
L8509 1 1
L8510 1 1
L8511 1 1
L8514 1 1
L8515 1 1

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