The Current Procedural Terminology (CPT) codes clinicians use to report services to health insurers have become a linchpin in the American health care system. These codes are federally mandated, and all health care providers must pay royalties to the AMA to use them. That’s a heck of a cash cow for the AMA.
In 2023, the AMA raked in a staggering $495 million in revenue. A full 62 percent, $308 million, came from royalties tied to the use of CPT codes. And every dollar is paid for by taxpayers, via Medicare and Medicaid, or employers and employees in the private health insurance market.
The AMA’s financial windfall is made possible by the federal government. In 1983, the Centers for Medicare and Medicaid Services (CMS) mandated that CPT codes be used to report services under Medicare Part B. By 1986, Medicaid programs also had to adopt these codes. The 1996 Health Insurance Portability and Accountability Act (HIPAA) then solidified CPT codes as the national standard for electronic health transactions. These federal mandates essentially forced every health care provider to rely on the AMA’s CPT code system, creating a monopoly. Cha-ching!
There is another model out there, though. The diagnoses being addressed by health care providers are tracked using International Classification of Diseases (ICD) codes. But ICD codes are free for use by any entity worldwide. There is no reason a similar system couldn’t be developed for CPT codes. //
The AMA has also publicly advocated against “policies excluding transgender individuals from restrooms and other facilities.” In other words, the AMA is perfectly fine with that weird teacher lurking in your middle school daughter’s locker room.
By promoting the trans agenda, the AMA is using its substantial influence — funded by taxpayer dollars through federally mandated royalties — to advocate for policies that Americans repudiated in the last election and that may not be in line with the views of many doctors or patients across the country.
