Medicare Claims Processing Manual (Pub. 100-04), Ch. 23 § 20.7
Use of the American Medical Association’s (AMA’s) Physicians’ Current
20.7 - Use of the American Medical Association’s (AMA’s) Physicians’ Current
Procedural Terminology (CPT) Fourth Edition Codes, and Use of the American Dental
Association’s (ADA’s) Current Dental Terminology-Fourth Edition (CDT) Codes, on
A/B MACs (A)’s, (B)’s, (HHH)’s, and DME MACs’ Web Sites and Other Electronic
Media
(Rev. 12573, Issued: 04-09-24; Effective:08-10-20; Implementation: 08-10-20)
See Business Requirements at http://www.cms.hhs.gov/manuals/pm_trans/R43CP.pdf
CMS AMA-ADA-AHA Medical Codes
Overview
The Centers for Medicare & Medicaid Services (CMS) staff may access the following copyright protected
medical codes and descriptors:
•
American Medical Association’s Current Procedural Terminology – AMA/CPT
•
American Dental Association’s Current Dental Terminology – ADA/CDT
•
American Hospital Association’s National Uniform Billing Codes – AHA/NUBC UB-04
CMS signed licensing agreements with the AMA, ADA, and AHA giving staff limited use of CPT, CDT,
and NUBC data codes and descriptors.
Access the CPT, CDT, or NUBC codes
Prior to accessing the codes, CMS staff must accept the terms and conditions of an association's licensing
agreement.
•
American Medical Association’s Current Procedural Terminology – AMA/CPT
o
AMA Terms and Conditions
o AMA CPT Exhibits Directory
•
American Dental Association’s Current Dental Terminology – ADA/CDT
o
ADA Terms and Conditions
o
ADA CDT Exhibits Directory
•
American Hospital Association’s National Uniform Billing Codes – AHA/NUBC
o
AHA Terms and Conditions
o AHA NUBC Exhibits Directory
Any proposed usage not covered by the current agreement requires the completion of a
https://surveys.cms.gov/jfe/form/SV_4UsBJoFDNs9qQD4. CMS, then, will negotiate your “new use” with
the appropriate association.