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Medicaid NCCI Edit Files

The complete updated Medicaid National Correct Coding Initiative (NCCI) edit files are posted here at the beginning of each calendar quarter. These data replace the Medicaid NCCI edit files from previous calendar quarters. The presence of a HCPCS/CPT code in a Procedure-to-Procedure (PTP) edit or a Medically Unlikely Edits (MUEs) value for a HCPCS/CPT code does not necessarily indicate that the code is covered by any state Medicaid program or by all state Medicaid programs. States cannot use the files here for processing and paying Medicaid claims.

How to Access the Files

This page provides links to NCCI Edit files, where you can filter, sort, share, and download the files. To download data as an Excel file, follow the links on this page to navigate to your file.

Note: Excel limits the number of rows that can be exported in a single CSV for Excel file to 1,048,576 rows. The Practitioner and Outpatient Hospital PTP edit files both contain significantly more rows than that.

To download the complete edit file as an CSV/TEXT file, click the file name from the list of "Complete Medicaid NCCI Edit Files".  From the new page, then select Download filtered view (CSV) link under the Access heading. The browser will start downloading the selected file. Once the downloading progress stops, drag the file into a desired folder. Right click on the downloaded CSV file, and select “Open with” and then click on the “Notepad”.

Complete Medicaid NCCI Edit Files for Calendar Quarter Beginning April 1, 2022

Complete Medicaid NCCI Edit Files for Calendar Quarter Beginning January 1, 2022

Medicaid Change Report Files

The Medicaid Change Report files contain only the changes made in the Medicaid NCCI edit files from the previous calendar quarter. Information on these files is contained in Change Report File Information (DOCX, 14.62 KB).