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Getting the latest healthcare news for you
Getting the latest healthcare news for you
A nonprofit is taking the AMA to court over CPT billing codes. PatientRightsAdvocate.org filed a federal lawsuit on August 12 arguing that the AMA's copyrights on its Current Procedural Terminology (CPT) system are invalid — and that the 11,000+ codes mandated by federal and state law should be freely accessible to the public. The AMA says it will fight back.
A nonprofit is taking the AMA to court over CPT billing codes.
PatientRightsAdvocate.org (PRA) filed a federal lawsuit on August 12 arguing that the AMA's copyrights on its Current Procedural Terminology (CPT) system — the backbone of medical billing and reimbursement — are invalid and unenforceable. PRA contends that because CPT is mandated by federal and state law in at least 45 states, the public should be able to access and use the more than 11,000 codes freely, without paying licensing fees to the AMA. If it wins, PRA plans to scan the 2026 CPT codebook and publish it online at no cost. The AMA says it will "vigorously defend" its intellectual property rights.
The lawsuit lands amid growing scrutiny of the AMA's grip on CPT. Senate HELP Committee Chair Sen. Bill Cassidy has probed the AMA's "monopoly," and CMS is actively seeking public comment on potential CPT alternatives as part of its proposed 2027 Physician Fee Schedule.
By the numbers:
Why it matters: If the court sides with PRA, it could upend the AMA's major revenue stream and reshape how medical billing codes are accessed across the entire U.S. healthcare system — potentially reducing costs for providers, payers, and ultimately patients, while raising open questions about who would fund CPT's ongoing maintenance.
