What are CPT codes?
We’re sure you’re already familiar with CPT codes, but incase you need a reminder, here’s the APA on CPT codes. https://www.ama-assn.org/practice-management/cpt/cpt-overview-and-code-approval
There’s a fee for using these?
Turns out, there is! The AMA has the authority to charge licensing fees for use of their CPT codes. https://www.ama-assn.org/practice-management/cpt/ama-cpt-licensing-overview
I’ve never heard of this before.
Frankly, we hadn’t either before we started receiving these charges last year. But we’ve looked into it and it is legitimate.
It’s just Theranest charging this fee?
Yes. The folks at TheraNest let us know they suspect they’re some of the first EHR companies the AMA is charging. They suspect it’s because their parent company is one of the biggest companies in the space.
We’ve reached out to TherapyNotes and they said they have no plans to ever levy this charge.
I don’t accept insurance. Will I still be charged this fee?
The fee applies if you’ve ever used a CPT code at all. That doesn’t just mean in insurance billing, that also includes in your progress notes or your diagnosis.
That is to say you may still be charged this fee even if you’re private pay only.
How much is the fee?
In 2021 and 2022 the AMA charged $17/year. In 2023 they’ve increased the fee to $17.50/yr. Theranest says they expect the fee to increase by $0.50 every year. Theranest is adding on a $1 processing fee. That makes the total charge from Theranest $18.50 for 2023.
This charge is every year?
Yes. Moving forward, we expect this fee every year. As noted above, we’re now expecting this fee to increase by $0.50 every year.
What about moving forward?
We’ve already been charged the fee for 2023 for those that have already used a CPT code. If we were charged for your CPT usage, we will reach out to you to let you know we unfortunately have to pass this cost on to you.
If you haven’t used a CPT code yet in 2023 but you do at a later date, we will be charged the licensing fee and we will subsequently charge you.
If you don’t hear from us, we weren’t charged for your CPT usage. (If, for example, you use TherapyNotes or you did not use CPT codes at all, we won’t need to collect this fee from you.)
So what do I need to do?
You don’t have to take any action.
If you have used CPT codes within Theranest, we will reach out to you to let you know we’ll be charging your card on file for this $18.50 fee. You won’t have to do anything. We’ll charge your card on file and we’ll take care of it.
I don’t like this. What options do I have?
If you’d like to avoid this fee, the team at TherapyNotes has said they have no intention of charging this fee in the future. If you’re interested in making a switch in your EHR, send us an email and we’ll help you get it set up and wave this fee.
Thank you for your understanding and patience. If there’s some other way we can be of service, please don’t hesitate to send us an email and let us know.