Medically Unlikely Edits Logic for Span-Dated Claims – New Implementation Date

By August 1, 2026: Billing team must audit and update billing workflows to eliminate span-date billing for all claims subject to Medically Unlikely Edits (MUEs). Specifically: (1) Configure billing system to require individual dates of service instead of span dates for MUE-subject procedures; (2) Update provider encounter forms and templates to enforce single date-of-service entry; (3) Communicate new billing requirements to all clinical staff and providers; (4) Test billing system changes with sample claims before September 1, 2026. Providers and billing staff must implement these changes across professional and facility billing. Failure to bill individual dates of service for MUE-subject claims will result in claim rejections and denials starting September 1, 2026. Reference Reimbursement Policy (RP)-035 Correct Coding Guidelines for specific MUE edits applied.