Submit a request – American Medical Association

Please select your request type. Once submitted, a ticket confirmation screen will provide a summary of the information you've provided (All AMA employees must be logged in to submit requests)

Your email address

Subject(optional)

Please confirm that all users will be internal to your organization.

If your commercial services or software solutions are provided to external clients, this is considered Distribution and will require a Distribution License Agreement. Please complete a Distribution License Request Form.

Are there users outside of your organization?

Does anyone outside of your organization have access to AMA Data File? Do you provide services or solutions to customers/clients outside of your organization that require the use of AMA Codeset(s)? If so, this is considered distribution and you must complete a Distribution License Request Form.

Will there be more than 25 users accessing the content?

How many users internal to your organization will be accessing the data file or the application that it is used within (whether or not they see AMA codes directly).

Organization Name

Please provide the legal name of the institution, company, or other entity that will appear on the contract

Organization Address

Please list the organization's primary address including CITY, STATE, ZIP CODE

Company Address - Country

Primary Contact Name

Who should be contacted for follow ups?

Primary Contact Title(optional)

Primary Contact Email

Web Site(optional)

Primary Contact Phone(optional)

Is your organization a Health Plan?

Number of Members

How many covered lives are under this plan?

Will the AMA data file be used within an internally developed or third-party software, application or system?

What is the name of third-party software, application or system?

If you will be using the data within a third-party system, that vendor most likely requires a Distribution License with the AMA and you may have to license directly with them. If you do not see your software vendor listed, please select "Other" and name the software vendor in the text box.

If you are using the data within an internally developed software, application or system, please indicate the type of system.

Name or Describe the software, application or system.(optional)

Please indicate the type of organization/setting/use for the AMA Data File

In what type of system will be you be using the Data File?

What is the care setting?

Please describe the setting type.(optional)

Parent Organization(optional)

Does your organization have a health plan?

How will the AMA Data File be used?

How many Billing Providers do you provide services to?

Billing Provider - A health care provider who renders medical services for which a fee is charged.

How many Billing Providers does your organization employ?(optional)

Billing Provider - A health care provider who renders medical services for which a fee is charged.

How many staffed beds are at this location?

How many Full Time Equivalents?

How many users will there be?

How many users will be accessing the software or application, whether or not they directly see AMA Data File content? For assistance calculating user, please refer to this article https://compliance.ama-assn.org/hc/en-us/articles/360061118074-Internal-Use-License-Agreement-Request-26-or-More-Users

Which Datafiles are you requesting?

Please note the YEAR of the file that you are requesting.

Comments or Questions

This is a required field. Please enter any additional comments or details that are necessary to complete this request.

Is your organization tax exempt?

Tax exempt organizations will need to upload a certificate of exemption

Clickwrap Agreement Acknowledgement

By checking this box, you affirm that you will comply with the Clickwrap Agreement (press CTRL+click to access and review in a new page https://compliance.ama-assn.org/hc/en-us/articles/4404366953111 )

The CPT Data File is a flat ASCII Data File and may not be what you are seeking for your research/educational purposes. An alternative resource is the CPT Professional Edition, available in print and eBook format in the AMA Store.(optional)

Check the box above to confirm that you are seeking to purchase the Data File.

Please check this box to confirm that you have attached your tax certificate below(optional)

Multiple files can be uploaded using the button at the bottom of this form

Attachments(optional)

Add file or drop files here