Not the AMA of yore
The American Medical Association (AMA) is not just leftist, but also on the take from the American taxpayer. Here’s how it works:
The Current Procedural Terminology (CPT) codes clinicians use to report services to health insurers have become a linchpin in the American health care system. These codes are federally mandated, and all health care providers must pay royalties to the AMA to use them. That’s a heck of a cash cow for the AMA.
In 2023, the AMA raked in a staggering $495 million in revenue. A full 62 percent, $308 million, came from royalties tied to the use of CPT codes. And every dollar is paid for by taxpayers, via Medicare and Medicaid, or employers and employees in the private health insurance market.
Who knew? Not I. But it’s been going on for a long time. Here’s the history:
In 1983, the Centers for Medicare and Medicaid Services (CMS) mandated that CPT codes be used to report services under Medicare Part B. By 1986, Medicaid programs also had to adopt these codes. The 1996 Health Insurance Portability and Accountability Act (HIPAA) then solidified CPT codes as the national standard for electronic health transactions. These federal mandates essentially forced every health care provider to rely on the AMA’s CPT code system, creating a monopoly. Cha-ching!
There are other codes such as the International Classification of Diseases (ICD), which is free. But adopting that or something like it would eliminate much of the funding the AMA uses to pay its administrators hefty salaries and to support and lobby for policies such as trans treatment for prisoners.
OK RFK, do you know this?
When looking at my billing history from my insurance, I noticed that many times the hospital/provider has to recode items to get paid. It scares the —– out of me to see “denied” for a several thousand dollar billing.
CPT codes & ICD codes are “apples” &”oranges” — but your concern is well-taken. CPT/ Current Procedural Terminology codes are about what is DONE & about HOW LONG IT TOOK. ICD/ International Classification of Diseases codes are about DIAGNOSES or “MEDICAL CONDITIONS” (that do not have a distinct diagnosis attached).
Your comment re leftist is on target. Since the recent election, my sense is that the AMA/ American Medical Assn has “turned down the volume” a bit.
@ RCP
I would say you are right about the AMA turning down the volume but I think we both know that doesn’t change what they are doing or want to be doing. They are just hiding.
@neo:There are other codes such as the International Classification of Diseases (ICD), which is free. But adopting that or something like it would eliminate much of the funding the AMA uses
ICD codes are already used on claims and have been required for Medicare and Medicaid since 1979… though they are already on the claims, there would be huge switchover costs to paying professional claims according to ICD procedure codes, and further switchover costs with every new version of ICD. I was working for an insurance company with the switch from ICD-9 to ICD-10 and since it’s a totally different classification system, there is no one-to-one crosswalk, it’s not easy to compare pre- and post- ICD-10 claims. ICD-11 will be adopted likely sometime between now and 2030.
More relevant is the RVU system that sets the level of Medicare payments. The AMA is in charge of that one too.
@RCP:ICD/ International Classification of Diseases codes are about DIAGNOSES
There are indeed ICD-10 procedure codes.
Martin, true — the AMA currently is just hiding its leftish wishes. Similarly, my once highly reputable medical school has “turned down the volume” — from a high decibel full blast right up until the last election. Recently, I was quite ill while away from home — & my sons wisely ruled out taking me to either of the two major medical school hospitals that then were nearby.
Nice scam they’re running.
When an organization gets a major part of its revenue from a particular source, it naturally directs its attention more to that source and its other activities become relatively less important. The AMA seems to be getting the majority of its revenue from the CPT system and related activities, and so it should be no surprise that other activities – i.e. its members – are less important.
The AMA was founded as the professional organization for America’s physicians. Over the years, the direction of the AMA has been less and less reflective of the goals of the average physician. Fewer and fewer physicians are members – probably less than 10%. Nevertheless the AMA would like to pretend that it represents the average American physician. It does not.
It is so everywhere: Leftists on the Boards that set policy and control corps and organizations drive us further and further Left. The Massachusetts Medical Society owns the NEJM; its editors all favor single payer health care, which they, all Harvard and Yale Lefties, desire to impose. I stopped subscribing 30 years ago because of its Leftism-boosting editorials.
I don’t remember how many decades ago I dropped my NEJM subscription because of their leftists editorial slant and policies push. Same with my AMA membership–I would just as soon join the Progressive wing of the Democrat Party as support the AMA now! Yet, they haven’t given up on me and continue to send me regular solicitations. Last time I checked they were all in on supporting Palestine and DEI as well as the “get in line, the government knows what’s best for you” healthcare.
As with the AMA, so with the ABA, the NEA, and other “professional expert” unions (which is really what they are).
Robert Conquest’s Three Laws of Politics:
(1) Everyone is conservative about what he knows best.
(EXAMPLE: Martha’s Vineyard and other “liberal” enclaves cheering illegals moving to (invading) Texas border towns, but not theirs.
(2) Any organization not explicitly right-wing sooner or later becomes left-wing.
(EXAMPLES too numerous to list; and even the explicitly right-wing ones eventually move left, also far too many examples.)
(3) The simplest way to explain the behavior of any bureaucratic organization is to assume that it is controlled by a cabal of its enemies.
(Change the “its” to “our” for a contemporary formulation.)
I prefer Moore’s emendation: “assume that it is controlled by a cabal of the enemies of the stated purpose of that bureaucracy.”
However, I think Iowahawk had the best observation of the process:
1. Identify a respected institution.
2. kill it.
3. gut it.
4. wear its carcass as a skin suit, while demanding respect.
https://www.isegoria.net/2008/07/robert-conquests-three-laws-of-politics/
https://x.com/iowahawkblog/status/664089892599631872?lang=en
Yup. I’ve known about the AMA for a couple decades or more.
Physicians used to be primarily small business men and women. And they paid dues to the AMA who represented them. Now, the two big changes are this switcheroo with the AMA being supported by the Federal coding system, and physicians being sucked into the big corporate borg. As corporate employees they’ve lost much of their autonomy. I don’t imagine it is a coincidence that so many not very old doctors have retired in recent years.
“DOJ Questions Science Journal [‘Chest’] about Bias, Trigger Free Speech Concerns”
https://www.washingtonpost.com/science/2025/04/18/doj-questions-chest-journal-science/
https://archive.is/04mhs
“… It has been brought to my attention that more and more journals like CHEST journal are conceding that they are partisans in various scientific debates,” U.S. Attorney Ed Martin wrote. …”