The AMA is changing how it calculates and determines CPT data file user licenses. NextGen Healthcare clients who purchased the 2017 CPT® Code Set will NOT automatically receive the updated 2018 codes as in previous years.
ACTION REQUIRED: Please contact your NextGen Healthcare account manager to purchase your 2018 CPT Code Set/Data File: Availability is expected in mid – to late – November.
NextGen Healthcare will continue to offer CPT and HCPCS codes, as well as RVU mapping, as part of the NextGen® Coding Update File. This value-add service enables seamless importing of pre-formatted codes directly into your EHR/PM system.
Learn more about 2018 CPT® Codes on the Success Community.
How it Works
The AMA has moved to a provider-based model to calculate and report use of CPT® data files. AMA made the change to improve how they determine CPT data file user licenses.
The provider-based model – AMA calls it “User Proxy Method” – attempts to approximate users of CPT codes in an ambulatory EHR/PM system by identifying the number of full-time equivalent providers at a practice – instead of actual “hands on the keyboard”/everyday users.
This method uses base metrics (e.g. staffed beds, number of billing providers) – plus multipliers based on industry data – to approximate the number of users on electronic health record practice management systems. The AMA tested this methodology extensively in 2016 and participating licensees reported the approach is both straightforward to use and provides a consistent and transparent method to calculate and report use of CPT data files. Find details of the AMA change here.
The Path Forward
The AMA requires purchase of CPT codes for all providers – whether electronic license or manual use. The change affects NextGen Healthcare clients and all other ambulatory distributors of the CPT codes.
- As previously noted, NextGen Healthcare clients who purchased the 2017 CPT Code Subscription will NOT automatically receive the updated 2018 codes as in previous years. Due to the change being instituted by the AMA, we have halted the automatic renewal process for 2018 codes.
- Every NextGen Healthcare client using the medical procedure software IMO Procedure IT Terminology product must update to the 2018 CPT codes since the IMO product will be mapped to the newest CPT code-set for 2018.
Review the AMA License Terms definition of a “provider,” found at http://www.nextgen.com/cpteula. Purchases through your NextGen Healthcare account manager must adhere to AMA requirements. Our goal is to ensure you purchase and use the correct number of licenses to lessen the chance of a future AMA audit. The AMA has been auditing the use of CPT codes more frequently. To protect your practice, it is essential to comply with all AMA rules.
Please contact your NextGen Healthcare account manager today to enjoy the benefits of having these pre-formatted codes imported effortlessly into your system