I think you may be looking at the MUE a little differently than Medicare intends for CHI services.
For Medicare CHI, the primary codes are:
* G0019 = First 60 minutes per calendar month
* G0022 = Each additional 30 minutes per calendar month
The fact that G0022 has an MUE of 2 does not necessarily mean the patient is limited to 90 total minutes per month. Rather, it generally means Medicare will allow up to two units of the add-on code on a single claim line/date of service.
So if you provided:
* 60 minutes = G0019
* 90 minutes = G0019 + 1 unit G0022
* 120 minutes = G0019 + 2 units G0022
The key question becomes whether Medicare allows reporting more than two units of G0022 in your MAC jurisdiction. CMS guidance for CHI states that G0022 represents "each additional 30 minutes per calendar month," and several Medicare resources note there is no frequency limit on G0022 as long as the services are medically necessary and properly documented.
If you're consistently exceeding 120 minutes in a month, I would:
1. Verify the current MUE file and adjudication indicator for G0022.
2. Review your MAC's CHI guidance.
3. Confirm whether the claim is actually denying for MUE or for another billing limitation.
4. Ensure documentation clearly supports all accumulated time and qualifying CHI activities.
Out of curiosity, which code are you seeing the MUE of 2 on G0022 specifically, or are you using a different CHI code set? That will help determine whether this is a true MUE issue or a misunderstanding of the monthly time structure.
Dee Daniels
Founder | Elevare Management Solutions
Revenue Cycle Management Consultant
www.elevaremgmts.com