Lawsuit Challenges AMA's Copyright on Medical Billing Codes
An advocacy group has sued the American Medical Association, arguing that CPT billing codes should be freely accessible because they are incorporated into law. The lawsuit claims the AMA's copyright is invalid and that charging fees for these codes increases healthcare costs. The group wants the court to affirm that no one can own the law.
The lawsuit, filed by PatientRightsAdvocate.org, contends that because CPT codes are written into federal and state regulations, they fall under the legal principle that no one can own the law. The group notes that a physical copy costs $137.89, while providers pay an annual licensing fee plus a per-user charge. The AMA reported $296.4 million in 2025 revenue from books and digital content, though observers caution that figure cannot be tied solely to CPT licensing.
The AMA has pledged to defend its intellectual property rights, describing CPT as a continuously updated, collaborative standard. The dispute follows a letter from Sen. Bill Cassidy questioning the AMA's monopoly and revenue from the codes, adding political scrutiny to the ongoing debate over healthcare pricing transparency.
This case could reshape how medical billing information is accessed across the healthcare system. If the court rules against the AMA, patients, providers, and technology firms may gain free access to CPT codes, potentially lowering administrative costs and increasing billing transparency. However, the AMA argues that licensing fees fund the ongoing maintenance and updating of the codes, so a ruling against it could affect the quality and timeliness of future code revisions. The outcome may influence how other privately owned standards incorporated into law are treated.