`medicare_code_units_limit`

Pack: medicare-pricing · Endpoint: https://gateway.pipeworx.io/medicare-pricing/mcp

How many units of a procedure code will Medicare pay for one patient in one day? Returns the NCCI Medically Unlikely Edit (MUE) — the maximum units allowed — with the adjudication indicator saying whether the limit is absolute or can be overridden with documentation, and the rationale for it. Answers “what is the MUE for 99213”, “how many units of this code can I bill”, “why was my claim denied for units”. Available for practitioner, outpatient hospital and DME settings, which have different limits for the same code. States the quarterly edit vintage in force. Sourced from the CMS National Correct Coding Initiative.

Parameters

Name	Type	Required	Description
`code`	string	yes	HCPCS/CPT code, e.g. “99213”.
`setting`	string	no	Which MUE table: “practitioner” (default), “outpatient_hospital”, or “dme”. The same code can carry different limits in each.

Example call

Arguments

{
  "code": "99213",
  "setting": "practitioner"
}

curl

curl -X POST https://gateway.pipeworx.io/medicare-pricing/mcp \
  -H 'Content-Type: application/json' \
  -d '{"jsonrpc":"2.0","id":1,"method":"tools/call","params":{"name":"medicare_code_units_limit","arguments":{"code":"99213","setting":"practitioner"}}}'

TypeScript (@pipeworx/sdk)

import { Pipeworx } from '@pipeworx/sdk';
const pipeworx = new Pipeworx();

const result = await pipeworx.call('medicare_code_units_limit', {
  "code": "99213",
  "setting": "practitioner"
});

Connect

Add this to your MCP client config, or use one-click install buttons:

{
  "mcpServers": {
    "medicare-pricing": {
      "url": "https://gateway.pipeworx.io/medicare-pricing/mcp"
    }
  }
}

See Getting Started for client-specific install steps.

medicare_code_units_limit