AMA announces SNOMED CT to CPT mapping initiative

CHICAGO - The American Medical Association (AMA) announced today an interoperability initiative to support electronic prior authorization by developing and deploying SNOMED CT^® to CPT^® terminology mappings.

Prior authorization creates unnecessary barriers to appropriate healthcare for patients and creates costly administrative burdens for physician. This initiative is designed to reduce that burden and support the Centers for Medicare & Medicaid Services (CMS) Health Tech Ecosystem and its effort to modernize prior authorization, improve interoperability, and help patients receive medically necessary care.

As CMS and the healthcare industry advance FHIR®-based prior authorization workflows ahead of the Jan. 1, 2027, compliance deadline, the AMA's mapping initiative will help make interoperable, real-time electronic prior authorization possible. By connecting clinical terminology with administrative coding, it lays the foundation for scalable automation that streamlines workflows, improves data exchange, and supports faster, more efficient prior authorization decisions.

"Modernizing prior authorization requires more than electronic bridges between software applications," said AMA President Willie Underwood III, MD, MSc, MPH. "It requires trusted, interoperable terminology assets that can support real-world clinical and administrative workflows. By helping bridge SNOMED CT clinical concepts and CPT procedural coding for prior authorization use cases, the AMA aims to support a more seamless, standards-based ecosystem for physicians, hospitals, payers, and patients."

The AMA is actively encouraging collaboration across the health technology ecosystem, including:

• Health plans and payers
• Electronic health record (EHR) developers
• Clearinghouses and intermediaries
• Prior authorization vendors
• Standards development organizations and implementation communities

The AMA is inviting ecosystem participants to:

• Participate in collaborative testing activities
• Attend technical and educational informational sessions
• Provide workflow and implementation feedback
• Validate operational use cases and data flows
• Help ensure the mappings support real-world prior authorization scenarios across specialties and care settings

The initiative will begin by targeting the prior authorization scenarios that have the greatest potential to reduce administrative burden and help patients receive timely care. The work aligns with emerging FHIR implementation approaches, Da Vinci implementation guides, and CMS interoperability priorities.

The AMA will work collaboratively with health plans, EHR vendors, health IT developers and other stakeholders to test and refine the mappings, ensuring they are practical scalable, and ready to support real-world workflows in clinical setting. The goal is to help physicians spend less time navigating administrative hurdles and more time caring for patients, while enabling faster, more consistent prior authorization decisions before the 2027 implementation deadline.

CMS and ONC have made electronic prior authorization a key part of their interoperability strategy because better-connected health technology can reduce unnecessary delays, improve information sharing, and help patients get needed care more quickly. The AMA initiative supports the broad health system collaboration that is essential to design and help accelerate the standards needed for faster, more automated prior authorization and better information exchange.

In the coming months, the AMA will bring together stakeholder organizations for technical working sessions, pilot projects, educational forums, and collaborative testing to help ensure the solution is practical, scalable, and ready for broad adoption.

Organizations interested in participating in testing, technical discussions, or implementation collaboration efforts are encouraged to contact the AMA at [email protected] to provide input or get updates as development progresses.