The CPT® code process

How the CPT Editorial Panel process works

The Current Procedural Terminology (CPT®) code set is maintained through a physician-led process designed to reflect how medical services are actually performed in clinical practice. Oversight of this work rests with the CPT Editorial Panel (Panel), an independent body convened by the AMA, which ensures that CPT codes remain accurate, clinically meaningful and usable across the health care system.

Why CPT codes change over time

Medicine is constantly evolving. New technologies emerge, care delivery models change and clinical practice advances. Because CPT codes are used to describe medical services across the health care system, they must evolve alongside those changes. The CPT process exists to make sure the code set continues to reflect real-world clinical practice, rather than becoming outdated or ambiguous.

Who can request a change to the CPT code set?

The CPT Editorial Panel process allows a wide range of stakeholders to request changes to the code set. Medical specialty societies, physicians and other qualified health care professionals, hospitals, laboratories, medical device and technology companies, payers, and other interested parties may all submit requests. These requests are made through a formal code change application (CCA), which serves as the starting point for review.

The role of CPT Advisors and Interested Parties in the review process

As applications move through the Panel review process, specialty society–appointed CPT Advisors provide critical clinical and coding insight. These physicians and qualified health care professionals evaluate requests within their areas of expertise and submit written commentary. Their input helps Panel members understand how a service is performed in practice and how it fits within the broader CPT framework. Furthermore, the Interested Party process allows any stakeholder to request the agenda materials and to provide written or verbal comments during the meeting.

How CPT Editorial Panel meetings work

As part of the open process for updating the CPT code set, the CPT Editorial Panel meets three times each year. Anyone can register to attend these hybrid meetings in person or virtually. Prior to each meeting, Panel members are assigned specific applications and receive the agenda materials at least 60 days in advance. This preparation period allows Panel members to review clinical evidence, consider stakeholder feedback and assess how a proposed change may affect the overall structure of the code set.

How decisions are made during the meeting

During the meeting, Panel members assigned as reviewers introduce each application and lead the discussion. Panel members, CPT Advisors, and meeting attendees are invited to participate. The discussion focuses on whether the proposed change accurately describes the service, aligns with CPT coding principles, and meets the applicable criteria for inclusion in the code set. The Panel does not consider payment or coverage policy as part of this process.

Possible outcomes of a Panel vote

After discussion, the Panel votes on the appropriate next step. A request may be approved as submitted, approved, tabled for additional review at the same meeting, postponed to allow more information to be submitted at a later Panel meeting, or rejected. Once the Panel has taken action, and following the meeting, the Summary of Panel Actions is posted to the AMA website, and AMA staff independently notify the applicant of the decision.

When approved changes take effect

Approved CPT changes follow a structured implementation schedule. Most changes are incorporated into the annual CPT code set and become effective on Jan. 1, with code books released in advance to support implementation. Certain categories of codes, including Category I immunization codes, Category III codes, Proprietary Laboratory Analyses (PLA) codes and Administrative Multianalyte Assays With Algorithmic Analyses Codes (MAAA) codes, follow alternative release schedules to allow adequate preparation time.

Reconsideration of Panel decisions

Applicants or other interested parties may request reconsideration of a Panel decision. This process is narrowly focused and should comply with the stated criteria for reconsideration. 

Process built for clinical accuracy & transparency

The CPT Editorial Panel process balances clinical expertise, transparency and consistency. By grounding decisions in clinical expertise and open deliberation, the process helps ensure that CPT remains a reliable and trusted foundation for describing medical services in a rapidly changing health care environment.

CPT process resources

• CPT application FAQs
• The CPT Editorial Panel Ad Hoc Workgroup Organizational Structure and Processes October 2011 (PDF)
• Request for reconsideration/review of CPT Editorial Panel Actions (PDF)
• Conflict of Interest Policy of the CPT Editorial Panel (PDF)
• CPT Confidentiality Agreement (PDF)
• Guidelines for Medical Specialty Societies Coding and Nomenclature Committee (Updated Oct. 1, 2017) (PDF)

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