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Picture of CPT® Codes for 2016 are NOW AVAILABLE!  Contact your Sales Rep

CPT® Codes for 2016 are NOW AVAILABLE! Contact your Sales Rep


CPT is a registered trademark of the American Medical Association. The NextGen® Coding Update File, available as of November 18, 2015, will include the AMA's 2016 CPT codes as well as HCPCS and RVU codes/descriptions.
Price: $25.00

 

Effective 2/1/2015,  please contact

insidesales@nextgen.com 

for all CPT® code purchases

  

  

General CPT® code information and guidance

  

The CPT® codes for 2015 have been available for purchase.  The CPT® codes for 2016 are expected to be available mid/late November 2015.  Enjoy the benefits of these pre-formatted codes that you will be able to import effortlessly into your system, and by understanding the AMA's licensing terms and conditions (see below) you will also be compliant with their definition of a "user" which will greatly decrease your chances of being audited in the future.  As an added convenience when you purchase the codes, we will automaticaly (for NextGen direct clients only) enroll You in our automatic code renewal to ensure You receive subsequent year codes and updates automatically by January 1st of each year.  Don't miss the opportunity to ensure your peace of mind by securing your CPT Code licensing.

 

Please note that your practice/enterprise should be minimally purchasing CPT® codes for the TOTAL number of Providers as well as all other "users" as defined by the AMA (see below).  Non-adherence may result in You being audited by the AMA for the use of their intellectual property.

  

Per the AMA, CPT codes are licensed on an individual (as opposed to concurrent) user basis.  The AMA considers an individual to be a CPT user if he or she directly accesses CPT data in a product or, in the case where CPT is embedded in a product and not directly accessible, relies on embedded CPT data to perform his or her intended function with the product or its output.

 More specifically, a “user” is an individual who:

  1. Accesses, uses and/or manipulates CPT codes and/or descriptions contained in the Electronic Product either at the input (the point at which data is entered into the Product), the output (the point at which data, reports, or the like are received from the Products) or both phases of using the Products; or,
  2. Accesses, uses and/or manipulates the Electronic Product to produce or enable an output that could not have been created without CPT embedded into the Product even though CPT many not be visible or directly accessible; or
  3. Makes use of an output of the Electronic Product that relies on or could not have been created without CPT embedded into the Product even though CPT many not be visible or directly accessible.

Therefore ...

Every Provider, regardless of whether they are a Full-Time, Part-Time, Mid-Level, or Resident, will need to be defined as a “user” for AMA purposes.  While other 3rd Party Content may be aligned with the number of full-time equivalent Providers, this is not the case for the CPT codes as per AMA rules.  The AMA expects that not only Providers (i.e., MDs, DOs, Dentists, PAs, RNPs, PTs, etc…) must subscribe and have a license for the CPT codes, but any front-office (i.e., making appointments using CPT codes), back-office (i.e., coders or those processing claims using CPT codes or working with reports), nurses, or other staff may also fall under their definition and will need to be included in the user counts.  Even Providers such as Residents or those working few hours must be included in the counts for CPT utilization.