CPT® Data for Practice Fusion & Veradigm® Systems
Optum, a trusted leader in medical coding, billing, and compliance solutions, works on behalf of the American Medical Association (AMA) as the exclusive authorized distributor and licensing agent of CPT® data for practices and facilities that rely on Veradigm (formerly Allscripts) clinical and administrative systems. We are here to help you be prepared for upcoming 2025 procedural coding and billing updates and ensure that you are compliant with the associated licensing terms of this vital coding terminology.
Data and Licensing Details
Optum has been an authorized distributor of the CPT® Standard Data File since 2020. If your organization has purchased the Data File from Optum in prior years, you can quickly and easily use this online order process to renew your annual license and access the 2025 CPT® Standard Data File.
2025 New or Renewal Orders? If this is a first-time order from Optum for your organization, or you are a first-time purchaser for an existing client organization, please call our customer service line at 1-800-464-3649, option 1.
This annual Data File renewal and corresponding licensing is required for all care organizations using:
CPT® Standard Data File Overview
Current Procedural Terminology (CPT®), created by the American Medical Association (AMA), is a standardized coding system for medical services and procedures.
More | + | CPT® Standard Data File Overview
CPT® provides a standard language and numerical coding methodology to accurately communicate across many stakeholders, including patients, the medical, surgical, diagnostic, and therapeutic services provided by qualified healthcare professionals.
The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. Specifically, CPT codes are used to report procedures and services to federal and private payers for reimbursement of rendered healthcare.
Pricing
The annual fee for licensing the CPT® Standard Data File for use in EHR systems is determined by the AMA's Ambulatory EMR User Proxy Model which is used to approximate the number of people in your practice who use CPT® codes, by multiplying the number of Billing Providers in the practice by four. This is an industry-wide methodology that yields a standardized number of users simply and systematically, allowing for the ebb and flow of administrative staffing without frequent licensing updates. More | + |information about Pricing
The definition of Billing Providers is any healthcare provider who renders medical services for which a fee is charged. If your total # of calculated licenses from this model is greater than the total number of your actual FTEs, or you need assistance with part-time providers (which are calculated at a partial rate, with the final number rounded up to the next whole number), please call our customer service line at 1-800-464-3649, option 1.
Usage of the CPT® Standard Data File in Veradigm® Practice Management is also determined by the number of Billing Providers in your practice, but at a one-to-one rate rather than with the 4x multiplier, with an additional $90 Data File fee applied.
For licensing questions or issues related to 2025 (or prior year) CPT® Standard Data Files, call 1-800-464-3649, option 1.
System Configurations and Pricing
What system(s) does your practice use?
Review and select from the list of five options below for your practice’s EHR/PM system configuration.
Ready to order?
Select and add your systems configuration to your shopping cart, then proceed to payment and licensing sign-off. It’s fast and easy!
Order Process and Details
How to Order
- Place your order.
- You will receive an Adobe Sign email to facilitate the digital signature of the CPT® Standard Data File license agreement; a copy of the signed license agreement will be emailed to you.
- Once you have digitally signed your license agreement, you will receive two more emails from Optum:
- An order confirmation email
- For Practice Fusion EHR and Veradigm® Professional, a license-activation email that includes a keycode that you will enter into your Veradigm system(s). Delivery of the Data File will be facilitated when the File is released in November 2024. At that time, you will be notified by Optum on the availability and access instructions to the Optum Data Vault, for download.
- Veradigm® Practice Management does not require a keycode; you will be directed to the Optum Data Vault via email when the file is released in November 2024.
Details and Disclaimers
- A credit card is required for purchase. Purchase orders and/or invoicing for deferred payment is not allowed for the 2025 CPT® Standard Data File.
- If this is a first-time order from Optum for your organization, or you are a first-time purchaser for an existing client organization, please call our customer service line at 1-800-464-3649, option 1.
- The CPT® Standard Data File is licensed on an annual basis. You will need to renew the Data File and corresponding license each year.
- Licensing grants the purchasing organization the authorization to use the 2025 CPT® Standard Data File. Manually loading the new codes without the applicable purchase and licensing is a violation of the copyright that the AMA owns and is subject to penalty.
CPT is a registered trademark of the American Medical Association.
Coding Clinics is a registered trademark of the American Hospital Association.
*Data only © 2024 FAIR Health, Inc.
