U.S. Senator Bill Cassidy, chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, has intensified his inquiry into the American Medical Association (AMA) regarding its management of the Current Procedural Terminology (CPT) coding system and the associated costs for families.
Earlier this year, the AMA did not respond to questions from the HELP Committee about how it sets fees for CPT codes. As a result, Cassidy has stated he will use all available means to obtain answers.
“I am concerned that the status quo focuses on enriching the AMA at the expense of patients, while the organization subsequently uses the revenue to advance a political agenda that is not representative of the majority of the medical community,” wrote Dr. Cassidy. “If you are unable to voluntarily reply in a fulsome and timely manner, the Committee will consider other options to secure the information requested from the AMA.”
Cassidy's concerns follow previous criticism directed at the AMA for supporting gender-transition procedures for minors and allegedly disregarding scientific evidence and federal directives.
In his letter addressed to Dr. Mukkamala of the AMA, Cassidy emphasized that openness and transparency are essential in health care. He reiterated his aim as HELP Committee Chair is to determine whether AMA’s current approach to managing CPT codes benefits patients or primarily serves organizational interests.
He pointed out that since 1983, only about 26% of U.S. physicians are members of the AMA despite its exclusive control over CPT code development. Cassidy asked what steps have been taken by AMA leadership to ensure feedback from all providers is considered.
The letter noted that last year, AMA reported $513.2 million in total revenue with $281.4 million coming from books and digital content sales but lacks clarity on how much specifically comes from CPT licensing.
Cassidy requested detailed information on revenue generated by CPT materials, administrative costs related to their production, pricing methods over recent years, and changes in these prices.
Additional questions focused on membership requirements for participation in editorial decisions around CPT codes and how input from interested parties is weighed during code changes.
He also raised concerns about confidentiality agreements required by AMA for those involved in code change processes and sought clarification on potential repercussions if these agreements are violated.
Regarding fees charged by AMA—including user access fees and royalties—Cassidy asked for data on users accessing licensing models in 2024 and details on how these fees are calculated across different stakeholders such as providers, hospitals, health plans, and software companies.
He questioned whether products like CPT Link software are mandatory purchases for digital access to CPT content.
Finally, Cassidy asked about financial ties between AMA’s House of Delegates and organizations supporting diversity mandates or gender-transition procedures. He also sought details about how membership fees support advocacy activities within the organization.
Cassidy set a deadline of December 15, 2025 for responses from AMA leadership and warned that further actions would be considered if answers were not provided.
