The American Medical Association announced on July 14 an interoperability initiative aimed at supporting electronic prior authorization by developing and deploying SNOMED CT to CPT terminology mappings.
According to the announcement, the initiative is designed to reduce administrative burdens for physicians and support the Centers for Medicare & Medicaid Services Health Tech Ecosystem in its efforts to modernize prior authorization, improve interoperability, and help patients receive medically necessary care. The AMA said that as CMS and the healthcare industry advance FHIR-based prior authorization workflows ahead of the Jan. 1, 2027, compliance deadline, this mapping initiative will help enable interoperable, real-time electronic prior authorization. By connecting clinical terminology with administrative coding, it aims to lay a foundation for scalable automation that streamlines workflows and supports faster decisions.
“Modernizing prior authorization requires more than electronic bridges between software applications,” said Willie Underwood III, MD, MSc, MPH, president of the American Medical Association. “It requires trusted, interoperable terminology assets that can support real-world clinical and administrative workflows. By helping bridge SNOMED CT clinical concepts and CPT procedural coding for prior authorization use cases, the AMA aims to support a more seamless, standards-based ecosystem for physicians, hospitals, payers, and patients.”
The AMA is encouraging collaboration across health technology stakeholders including health plans and payers; electronic health record developers; clearinghouses; intermediaries; vendors; standards organizations; and implementation communities. The organization is inviting participants to join collaborative testing activities such as technical sessions and pilot projects in order to validate operational use cases across specialties.
This work aligns with emerging FHIR implementation approaches as well as CMS interoperability priorities. The AMA said it will collaborate with stakeholders throughout development in order to test and refine these mappings so they are practical and scalable before the 2027 deadline. In coming months, it plans technical working sessions intended for broad adoption.
The American Medical Association has influenced medical ethics standards nationwide through collaboration with state societies while advocating reforms in Medicare payments among other initiatives, according to its official website.