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The nonprofit PatientRightsAdvocate.org (PRA) has filed a lawsuit against the American Medical Association (AMA) seeking to make Current Procedural Terminology (CPT) codes available to the public and health organizations free of charge, according to an announcement. Federal law requires healthcare entities to use CPT for Medicare claims, and most payer policies—including among state Medicaid programs—use CPT codes for billing as well. AMA has held the copyright for CPT since 1966, and it charges organizations for access and licensing. For example, providers are charged an annual fee of $82.50 plus $18.50 per user for the electronic CPT resource, according to PRA. In 2025, the AMA reported $296.4 million in revenue from books and digital content, which PRA says largely can be attributed to licensing CPT codes. PRA is seeking the right to scan and publish the 2026 CPT codebook and future editions in a free, searchable online format. The organization argues that CPT cannot be protected by copyright because it has been incorporated into federal and state law. The lawsuit also contends that free publication would qualify as fair use.
Weigh in: In its proposed 2027 physician payment rule, the Centers for Medicare & Medicaid Services has requested public comment on concerns related to CPT licensing, potential objective alternatives to CPT as the national coding standard for services, and CPT’s effects on clinician payment. Any alternative system would undoubtedly be phased in over a long period of time because CPT is so entrenched across the healthcare industry. Regardless, the payment proposal document includes a brief history of the CPT system, which makes for an interesting read.