How the American Medical Association Screws Doctors
27th March 2025
CPT codes are a way to explain what a clinician did during an interaction with a patient. For instance, the most common CPT code for psychologists is 90837, which is the number that means the clinician provided an hour of psychotherapy. To get payment, they will submit this code to health insurers, whether private, Medicare, or Medicaid, and everyone involved will know what it means. First developed in 1966 for use with Medicare, the demand for extensive medical documentation is now a serious contributor to physician burnout, as “[f]or every 8 hours of scheduled patient time, ambulatory physicians spend more than 5 hours on the electronic health records.”
CPT codes are developed by a panel of 21 medical professionals selected by the AMA Board of Trustees who meet three times a year to solicit input from across the medical industry on the latest medical care to create, revise, remove, and determine the relative value of the codes (these relative value units influence insurance reimbursement rates). Twelve panel members are nominated by national medical specialty societies like the American Academy of Thoracic Surgery, while several seats are occupied by representatives from the health insurance industry.
In other words, the AMA isn’t offering a software product. It just runs this process, keeping a list of codes that map to different medical procedures. You would think it would be free, a standard for everyone to use. But it’s not, and the AMA is able to charge a royalty for the license to use those codes. Every medical software company seems to have CPT codes and royalties built into their workflow.