MUE limits — Practitioner Services
Get MUE limits for a code in the Practitioner Services table.
Authorizations
Path Parameters
Billing or terminology code value (CPT/HCPCS/NDC/etc depending on endpoint context).
Query Parameters
Date of service (YYYY-MM-DD); selects the NCCI version active on that date. Defaults to today.
Include AI-generated clinical summary
Response
Successful Response
MUE (Medically Unlikely Edit) for a single code + setting.
HCPCS/CPT procedure code
AI-generated plain-English summary
Service date used for lookup
MAI label: '1 Line Edit', '2 Date of Service Edit: Policy', '3 Date of Service Edit: Clinical'
CMS rationale (e.g. Clinical: Data)
MUE table: practitioner, hosp-op, or dme
Maximum units of service per encounter
SENTINEL trust verdict for the AI summary. Present whenever include_summary=true. Use sentinel.escalation_required to decide whether to show the summary unattended or route it to a human reviewer.
Effective date of the CMS NCCI version
Date the CMS version was posted