The AMA CPT codes have a tortuous history and are currently in a legally ambiguous place supported by aggressive AMA lawyers. It is similar to the legally tenuous position of the RIAA that they can control what you can do with the music you have purchased.
A short history. In testimony before congress in 1997, T. Reginald Harris, Chairman of the AMA CPT Editorial Board stated: "The AMA has taken additional steps to make CPT available over the Internet and is expected to complete an agreement with the HCFA in the very near future. Under the agreement, complete public access to HCFA data files containing CPT will be available, free of charge, both domestically and internationally." Congress then passed legislation mandating use of the CPT codes for medical billing. However, the AMA did not make the codes freely available domestically and internationally. Instead, they have been selling the codes under very restrictive licensing agreements and in fact earn tens of millions of dollars a year from these fees. The AMA has been very aggressively policing "misuse" of the codes (for example, taking legal action against people who have made the codes "freely available on the Internet"). Their legal position is tenuous and has never been tested fully in court. Instead, they have relied on the intimidation of their lawyers to produce compliance. Similar cases such as Feist v. Rural Telephone and DrewTech v. SAE have produced results which would seem to prohibit the AMA from charging for the codes. That said, it is probably best not to challenge the AMA. Our corrupt politicians should address the problem but of course, they will not go against a big contributor. You can buy the codes for use (under their restrictive license) from the AMA and that is probably the best course of action. /Mark Alex Caldwell wrote: > > --- In openhealth@yahoogroups.com, Tim Cook <[EMAIL PROTECTED]> wrote: > > > > Alex Caldwell wrote: > > The way I interpret the agreement on > > > the site, I believe it is OK to do this as long as you just do it > > > just for yourself for your own internal use, but you are not allowed > > > to re-distribute them. So perhaps it would be OK to distribute the > > > Open Source EMR minus these codes, but include instructions for the > > > user for downloading this file and importing the codes themselves > > > into their own personal copy of the EMR????: > > > > DISCLAIMER: IANAL but.... > > > > "Grant and Limitations. You, as an individual, are authorized to use > > CPT only as contained in the CPT®/Medicare Relative Value Payment File > > (the "File") solely for your own personal information and only within > > the United States." > > > > specifically EXCLUDES any use outside of the (Excel) file and any use > > outside the US. It goes on to say that you are prohibited for using > > them in place of purchasing the CPT book or creating any derivative > > work. > > > > When we licensed CPTs for use in FreePM the AMA was very attentive to > > the distribution and we had to submit quarterly audits to them. I > > suggest you ensure you adhere to their licensing restrictions I > > understand they are very aggressive in pursuing their copyright on > > their government granted monopoly. > > > > Cheers, > > -- > > Timothy (Tim) Cook, MSc > > Thanks Tim, > > I was going by the agreement on this page on the CMS site which links > to the download for the Excel file: > > http://www.cms.hhs.gov/apps/ama/license.asp?file=http://new.cms.hhs.gov/apps/ama/report_xyz.pdf > > It did not seem to me as restrictive as what you are quoting there. I > notice many doctors do things with CPT, such as having them printed > by a local printing house on their own customized superbills. I've > never heard of anyone being pursued for that. It would seem that if > you included a subset of the CPT codes that you use in your own > practice in order to interact with Medicare for billing transactions > in the course of your own business, and you get them yourself for > your own personal use, not distributed with the EMR, but just loaded > into it by yourself, it would not violate the conditions. I cannot see > that loading a subset of CPT codes into your EMR would be any > different than printing them on a superbill or having your coder enter > then into your claims. But that's just the way I look at it, which > may not hold up. I imagine CMS and other 3rd party payors and > clearinghouses must have agreements with AMA to use CPT. Do their > agreements extend in any way to cover individual providers that do > business with these 3rd party payors that use CPT? > > Alex > --- In openhealth@yahoogroups.com, "Alex Caldwell" <[EMAIL PROTECTED]> wrote: > > --- In openhealth@yahoogroups.com, Tim Cook <tw_cook@> wrote: > > > > Alex Caldwell wrote: > > The way I interpret the agreement on > > > the site, I believe it is OK to do this as long as you just do it > > > just for yourself for your own internal use, but you are not allowed > > > to re-distribute them. So perhaps it would be OK to distribute the > > > Open Source EMR minus these codes, but include instructions for the > > > user for downloading this file and importing the codes themselves > > > into their own personal copy of the EMR????: > > > > DISCLAIMER: IANAL but.... > > > > "Grant and Limitations. You, as an individual, are authorized to use > > CPT only as contained in the CPT®/Medicare Relative Value Payment File > > (the "File") solely for your own personal information and only within > > the United States." > > > > specifically EXCLUDES any use outside of the (Excel) file and any use > > outside the US. It goes on to say that you are prohibited for using > > them in place of purchasing the CPT book or creating any derivative > > work. > > > > When we licensed CPTs for use in FreePM the AMA was very attentive to > > the distribution and we had to submit quarterly audits to them. I > > suggest you ensure you adhere to their licensing restrictions I > > understand they are very aggressive in pursuing their copyright on > > their government granted monopoly. > > > > Cheers, > > -- > > Timothy (Tim) Cook, MSc > > Thanks Tim, > > I was going by the agreement on this page on the CMS site which links > to the download for the Excel file: > > http://www.cms.hhs.gov/apps/ama/license.asp?file=http://new.cms.hhs.gov/apps/ama/report_xyz.pdf > > It did not seem to me as restrictive as what you are quoting there. I > notice many doctors do things with CPT, such as having them printed > by a local printing house on their own customized superbills. I've > never heard of anyone being pursued for that. It would seem that if > you included a subset of the CPT codes that you use in your own > practice in order to interact with Medicare for billing transactions > in the course of your own business, and you get them yourself for > your own personal use, not distributed with the EMR, but just loaded > into it by yourself, it would not violate the conditions. I cannot see > that loading a subset of CPT codes into your EMR would be any > different than printing them on a superbill or having your coder enter > then into your claims. But that's just the way I look at it, which > may not hold up. I imagine CMS and other 3rd party payors and > clearinghouses must have agreements with AMA to use CPT. Do their > agreements extend in any way to cover individual providers that do > business with these 3rd party payors that use CPT? > > Alex >
