AMA’s new CPT mapping initiative targets prior authorization automation

Advertisement

The American Medical Association is launching an initiative to develop and deploy SNOMED CT to CPT terminology mappings that support electronic prior authorization.

The project aims to reduce administrative burden for physicians and help patients receive timely care by connecting SNOMED CT clinical concepts with CPT procedural coding, according to a July 14 AMA news release. It supports the CMS Health Tech Ecosystem’s push to modernize prior authorization and improve interoperability ahead of a Jan. 1, 2027, compliance deadline for FHIR-based prior authorization workflows.

The AMA is inviting health plans, EHR developers, clearinghouses, prior authorization vendors and standards organizations to join collaborative testing, technical sessions and workflow feedback efforts, according to the release. 

The initiative will first target the prior authorization scenarios with the greatest potential to cut administrative burden, aligning with FHIR implementation approaches, Da Vinci implementation guides and CMS interoperability priorities.

In the coming months, the AMA will convene stakeholders for technical working sessions, pilot projects and educational forums to refine the mappings before broad adoption. 

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Register to Attend Webinar

Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

Advertisement

Next Up in Payer

Advertisement