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The Billing Override Rules screen lets administrators configure payer-specific billing suggestion rules, accessible at /cl/settings/billing-overrides.

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Overview

The page queries pm_billing_suggestion_rules (joined to pm_payers) for the current organization, filtered by deleted_at IS NULL and ordered by priority descending. Rules are split across three URL-synced tabs: “CPT Mappings” (cpt_mapping), “Modifier Overrides” (modifier_override), and “Never Suggest” (never_suggest). Each tab shows an active-rule count badge. Each rule row has an inline Active toggle (calls toggleActive mutation), and a kebab menu with Edit, Duplicate, and Delete actions. The “Add Rule” button (gated to cl.billing_overrides.manage) opens BillingOverrideRuleFormDialog. Deleting requires confirmation: “Delete this rule?” / “It will be removed from active suggestions but can be restored by an administrator.”

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Who it’s for

Requires permission: cl.billing_overrides.view (read); cl.billing_overrides.manage (create/edit/delete)

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Before you start

  • You must hold cl.billing_overrides.view to access the page.
  • Creating, editing, or deleting rules requires cl.billing_overrides.manage.
  • Rules apply organization-wide; coordinate with billing staff before modifying.

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Steps

1

Navigate to Billing Override Rules

Go to /cl/settings/billing-overrides. Rules load from pm_billing_suggestion_rules for your organization.
2

Select a rule type tab

Choose “CPT Mappings,” “Modifier Overrides,” or “Never Suggest.” The active count badge on each tab reflects currently active rules.
3

Toggle a rule active or inactive

Use the Active switch on any row to enable or disable a rule without deleting it.
4

Create a new rule

Click “Add Rule” (requires cl.billing_overrides.manage). The BillingOverrideRuleFormDialog opens with the current tab’s rule type pre-selected.
5

Edit or duplicate an existing rule

Open the kebab menu on a row and select “Edit” or “Duplicate.” Duplicate pre-fills the form as a copy of the selected rule.
6

Delete a rule

Select “Delete” from the kebab menu. Confirm in the dialog (“Delete this rule?”) to soft-delete the record.

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Key concepts

The active tab is synced to the URL via useTabUrlState using the tab query parameter. Valid values: cpt-mappings, modifier-overrides, never-suggest.
Per tab: “No CPT mapping rules yet,” “No modifier override rules yet,” or “No suppression rules yet” — each with a “Create your first rule to customize billing suggestions.” prompt and an “Add Rule” action.
If the query fails, a destructive error panel is displayed with a “Retry” button that calls refetch().
The Conditions column renders badge chips for each non-null key in condition_config. The semantic meaning of these keys is not documented in the UI.
The Effective column displays “Always” when both effective_date and end_date are null. Otherwise it shows “From ” and/or “To ”.

Clinical

Overview of the Clinical core.

Governance & parity

Documentation coverage and governance.
This page documents shipped product behavior. It is not medical, legal, or billing advice. Verify against your organization’s policies and applicable regulations before using it for clinical, compliance, or billing decisions. Protected health information (PHI) shown in the product is governed by your tenant’s access controls and is never exposed in this documentation.
  • src/routes/cl.tsx
  • src/cores/cl/pages/BillingOverrideRulesPage.tsx
  • src/cores/cl/hooks/useBillingOverrideRulesMutation.ts