A nonprofit patient advocacy group has filed a lawsuit seeking to open the American Medical Association’s copyrighted Current Procedural Terminology (CPT) up for free use.
The complaint, shared Thursday by PatientRightsAdvocate.org (PRA), explains that because the administrative codes for classifying medical procedures have been ingrained into government systems and electronic healthcare transactions by law, their use by the public has become unavoidable.
Use of the system and requests for any physical copies for “personal use” require payments to the AMA, which first developed the CPT system in the 1960s and registers copyrights for each of its annual revision.
PRA wrote that the AMA “has no right to withhold CPT from the public and charge hefty fees for access,” citing legal copyright precedent that suggest portions of statute cannot be owned. Hedging that argument, the group added that even if the copyright is found to be valid, public access to CPT should still be guaranteed under fair use and copyright misuse principles.
“PRA therefore brings this declaratory judgment action to clarify that it can make CPT freely available to the public at large,” the group wrote in its complaint. “In particular, PRA has purchased a 2026 print edition of CPT, which—if it prevails in this suit—it intends to scan and post on its website for the public at large to access without charge. But at present, PRA cannot take these next steps without risking a ruinous copyright infringement lawsuit brought by the AMA.”
PRA notes that the AMA reported $296.4 million of revenue and $267.5 million in profit during 2025 from “Books and Digital Content,” a reporting category for which it understands that “licenses and sales of CPT represent the overwhelming share of this revenue.” The AMA charges members of the public $137.89 for a physical copy of CPT, and providers an upfront annual fee of $82.50 plus an $18.50 per user annual fee, according to the complaint.
“These egregious charges ultimately are increasing the costs of healthcare for American patients and employers, unnecessarily,” Cynthia Fisher, PRA’s founder and chair, said in a statement. “We are asking the court to affirm a basic principle: No one can charge the public to access standards that are incorporated into state and federal law.”
The AMA, which is the nation’s largest physician organization with around 300,000 dues-paying members, did not immediately respond to a request for comment.
The CPT system’s role in healthcare, and particularly AMA’s resulting influence over areas like Medicare reimbursement rates, has faced fresh scrutiny in recent months from lawmakers and the Centers for Medicare and Medicaid Services alike.
Senate Health, Education, Labor and Pensions (HELP) Committee Chair Bill Cassidy, M.D., launched information requests late last year related to how AMA determines new codes, pricing and how the organization uses revenues it receives through its ownership of CPT. Rep. James Comer, R-Kentucky, who chairs the House Committee on Oversight and Government Reform, in June asked CMS for its thoughts on whether the system’s complexity and structure was facilitating improper billing such as upcoding or unbundling, and whether it would need any help hypothetically moving away from the system.
CMS, for its part, has begun exploring just that issue, including in its Calendar Year 2027 Physician Fee Schedule proposed rule a call for public comment “on a number of areas regarding the influence of the CPT coding system and AMA process on physician payment policy as part of the Secretarial priority to Make America Healthy Again." CMS also described in that request a relatively novel interpretation of statute in which the agency is not explicitly instructed on how it should be using CPT for electronic healthcare transactions.
PRA cited each of these examples of government pushback in its lawsuit as a rising wave of federal government pushback against the AMA’s longstanding use of the CPT system.