CPT® licensing for health care delivery organizations

Hospitals, ambulatory clinics, physician groups and other organizations involved in care delivery use Current Procedural Terminology  (CPT®) coding in many different workflows, settings and systems. 

The AMA licenses thousands of organizations to use CPT data in a broad array of applications. The AMA’s licensing model for CPT is based on individual users. In each of these cases, organizations that utilize CPT in their systems are required to obtain a license for each individual application—regardless of the number of codes used in the application.

The AMA revises CPT codes annually that reflect the ever-changing innovations in medical practice. To ensure CPT codes fairly and accurately reflect the medical care provided to patients, the AMA maintains a process that involves the direct input of practicing physicians, allied health professionals and advisors representing all aspects of the healthcare ecosystem.

Submit an application to begin the process

CPT Licensing Application

Determining users for each CPT application

For those who require licenses for a system, simply count the individual users of CPT for each application and report them to the AMA to develop your license. Please review the definition of a user to make sure users are counted correctly for each application and for all types of uses.

To determine the number of users for electronic medical records (EMRs), patient billing and practice management systems, AMA has developed the User Proxy Model—a method to approximate the number of users by employing base metrics—which includes a toolkit to assist you.

The AMA uses standard health industry data for the purposes of determining the appropriate number of users for licensing CPT. The sources of data include, but are not limited to, HIMSS Analytics, the American Hospital Association, CMS Attestation Reports and information available in the public domain.

Use of CPT® codes when complying with 2019 IPSS/LTCH final rule

Organizations that have a valid and current CPT license for their chargemaster (which typically is a component of a revenue cycle management system) are permitted to post their chargemaster for the limited purpose of complying with the 2019 IPSS/LTCH final rule, effective Jan. 1, 2019 (i.e., solely to the extent necessary to make available a list of their current standard charges via the internet in a machine readable format and to update this information at least annually, or more as appropriate).  Organizations that do not have a current license for their revenue cycle management system which uses CPT content, please submit a CPT Licensing Application to begin the process.