Kennedy asks what the AMA's CPT codes cost, and practices have until Sept. 14 to answer

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. posted a video Aug. 27 directing Americans to comment through the Federal Register on the future of medical coding and billing, saying organizations across the health care system paid the American Medical Association (AMA) more than $300 million last year to use Current Procedural Terminology codes.

The docket is the CY 2027 Medicare Physician Fee Schedule proposed rule, file code CMS-1848-P. It closes Sept. 14 and had drawn more than 19,000 comments as of Aug. 31.

The AMA says licensing revenue funds the development and maintenance of the code set. CPT underpins interoperability across the health system, the association said when it released the 2026 codes, and without a shared language health information stops moving cleanly and patient access suffers.

The video (above), which was shared on the official HHS YouTube channel, as well as on the MAHA Action account on X, formerly Twitter, directs viewers to the Federal Register.

What CMS is asking

Section II.H of the 716-page rule asks commenters to identify harms or challenges tied to AMA licensing of CPT-4, including licensure cost and delayed innovation. It asks whether private competition could supplement the standard, what alternatives exist to the AMA/Specialty Society Relative Value Scale Update Committee and whether ICD-10-PCS could serve as a payment basis.

CMS cited “longstanding concern expressed over the Federal reliance on a private organization with such an obvious conflict of interest.”

CMS has proposed nothing here. An RFI carries no timeline and no requirement that the agency act. In the same rule, CMS proposes accepting close to 100% of the AMA’s direct practice expense recommendations for 2027.

What your practice is licensing

CPT license fees run $18.50 per year for each user, AMA CEO John Whyte, M.D., wrote to Sen. Bill Cassidy, M.D., R-Louisiana, on Oct. 23, 2025, responding to a letter Cassidy sent that October.

Health plans pay 24 cents per member per year. Whyte rejected the characterization that the fees are exorbitant or that they push up health care costs. Providers also pay an annual access fee of $82.50, and a physical copy of the code set costs $137.89.

The per-user structure is where practice managers should look first. Royalties are set as an annual per-clinician or per-user charge regardless of claim volume, so a part-time clinician, a supervising physician who rarely bills and a staff member with system access can each carry a fee. SimplePractice, one electronic health record company, passes through $20 per clinician per year and bills every paid clinician on the account.

A practice running an EHR, a clearinghouse, a coding reference tool and an outsourced billing vendor may be paying CPT royalties inside four separate contracts without a line item that names them.

Pulling those agreements and identifying where the royalties sit is worth doing before commenting, because CMS asked specifically about the cost of licensure, and comments carrying documented practice-level numbers tend to land harder than general objection.

What a coding transition would look like

The 2027 rule already contains four small versions of it. CMS proposes bundling 17 remote physiologic and remote therapeutic monitoring CPT codes into four new HCPCS G-codes. It proposes new G-codes for advance care planning clinical staff time, reserving CPT 99497 and 99498 for the billing practitioner’s own time. It proposes a G-code for pediatric speech-language pathology services and another for shared medical appointments.

Each carries the same operational tail: charge master and fee schedule updates, EHR and practice management remapping, superbill revisions, coder and front-desk retraining, and elevated denial risk while payers and staff catch up. Commercial payers benchmark against Medicare methodology, so changes rarely stay confined to Medicare fee-for-service.

A broader move away from CPT would multiply that across every service line and would reach payer contracts that reference CPT by code.

The other changes in the same comment window

Both conversion factors decline, from $33.57 in 2026 to $33.17 for qualifying alternative payment model participants and $32.84 for everyone else.

CMS proposes converting the G2211 complexity add-on into a modifier that raises the underlying office or outpatient evaluation and management payment by 16%, with a second modifier worth 32% for Medicare Shared Savings Program and LEAD Model participants.

It proposes reducing payment for the lesser service when a procedure and a separate E/M visit are billed together, a broader version of a modifier 25 cut CMS withdrew after pushback in 2019. It proposes sunsetting the Merit-based Incentive Payment System after the 2028 performance period.

MGMA published a member analysis of the proposed rule July 22.

The litigation alongside it

PatientRightsAdvocate.org sued the AMA in Illinois federal court in mid-August, seeking to invalidate the CPT copyrights so it can publish the 2026 code set free in searchable form. Federal and state law incorporate CPT by reference, the complaint argues, and copyright precedent holds that no one can own the law. The claims are untested.

An AMA spokesman told MedPage Today the association will vigorously defend its intellectual property rights, describing CPT as medicine’s uniform language maintained through an open process.

The CPT Editorial Panel costs the government nothing, Whyte wrote to Cassidy. Twelve of its 21 members are appointed by national medical specialty organizations, CMS, the Centers for Disease Control and Prevention and the Food and Drug Administration each hold a non-voting liaison seat, meetings are open to any stakeholder, and the panel posts its agenda 60 days ahead and a summary of actions about 14 days after each meeting.

The AMA has not responded publicly to Kennedy’s video.

Comments go to regulations.gov under docket CMS-2026-2377, file code CMS-1848-P, by Sept. 14.