License required for everyone that uses CPT codes?

judyp53

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Looking for anyone that has heard from their software vendor that every user in the organization (providers, coders, data entry staff, front desk, nursing staff, etc) who use any of the CPT codes is required to have a license from the AMA. We've been told that AMA requires everyone to have a license if they have anything to do with any CPT code - all the way from picking a code for billing, to submitting the claims, to ordering tests/procedures, to running reports using the CPT codes. Is this something new? When did it start? Has anyone been audited by AMA? Have been told there's an initial license fee of approximately $275, then an additional fee of $35 per user, if you license thru the AMA. Thanks.
 

Pam Brooks

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I think there might be some confusion. Typically all software vendors require licenses (their own) for anyone using their software. This covers the licensure required for the software company to pay the AMA for the use of copyrighted CPT codes for billing/coding purposes, but also covers connectivity, access, auditing, and may include their support services, depending on the contract. It sounds like the software company is making it sound like the AMA is asking for the licensing, when it's in fact, them. Just a guess though.

I don't need a license from the AMA to use my billing software, but the software licenses me as a user.
 

CodingKing

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It seems weird to me that fee wouldn't already be included in whatever monthly or annual fee is charged per license (login) user. Obviously each person would need their own login as HIPAA (or just copyright law?) doesn't allow sharing of logins
 

thomas7331

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It's true the AMA does require licensing for users to have access to CPT within the electronic health records. A facility I worked with, as I heard it, did run into problems with the AMA for this because their licenses were not in order. I don't think it's necessary to have a separate license for each user though - I believe the contracts do allow for a license to cover everyone in the organization based on the size of the practice, but that's something you'd have to work out in the details of your contracts.
 

vcooper

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Licesining required for every user within a practice for CPT, ICD-10 and HCPCs

I received notification today stating from our software vendor stating AMA holds the copyright to the CPT code set and we need to have a license to use CPT within the product. Our software vendor is not an authorized distributor. I contacted the AMA and they do require us to get a license for anyone who falls under the following:

With regard to your User count, a "User" is defined as an individual who:
(a) accesses, uses, or manipulates the Licensed Materials; or
(b) accesses, uses, or manipulates a program which includes the Licensed Materials to produce or enable an output (data, reports and the like) that could not have been created without the Licensed Materials embedded in the program even though the Licensed Materials may not be visible or directly accessible; or
(c) makes use of an output of a program which includes the Licensed Materials that relies on or could not have been created without the Licensed Materials embedded in the program even though the Licensed Materials may not be visible or directly accessible.

This is pretty much everyone within our company of over 100 employees. This is going to be expensive if it's $35 for each user after the initial fee.

Also, when I went to fill out the request for licensing, it requires I input the same information for CPT, ICD-10's and HCPCs.

Does anyone else have any information regarding this?
 

gpugh0501

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It has come to my attention today that the AMA is requiring every user to have licensing??? I thought the EMR vendors were responsible for paying the AMA for CPT licenses?? can anyone shed some light on this?
 

trarut

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Not aware of licensing required in our EHR but our PM system requires separate AMA licensing for CPT codes. This started 3-4 years ago due to changes in the way AMA licensed use of the codes - or so we were told. It used to be that the PM system had a single license that licensed CPT for all subscribers. Now, we have to purchase an AMA license for each of our providers (not each user!); I believe it is $20-$25 per year per provider.
 
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