PRACTICE MANAGEMENT INFORMATION CORPORATION v.
THE AMERICAN MEDICAL ASSOCIATION
121 F.3d 516 (9
BROWNING, Circuit Judge:
Practice Management Information Corporation ("Practice Management") appeals from a partial
summary judgment and preliminary injunction forbidding it from publishing a medical procedure
code copyrighted by the American Medical Association ("the AMA").
Over thirty years ago, the AMA began the development of a coding system to enable physicians
and others to identify particular medical procedures with precision. These efforts culminated in the
publication of the Physician's Current Procedural Terminology ("the CPT"), on which the AMA
claims a copyright.
The current edition of the CPT identifies more than six thousand medical procedures and pro-
vides a five-digit code and brief description for each. The CPT is divided into six sections - evalua-
tion, anesthesia, surgery, radiology, pathology, and medicine. Within each section, procedures are
arranged to enable the user to locate the code number readily. In the anesthesia section, procedures
are grouped according to the body part receiving the anesthetic; in the surgical section, the proce-
dures are grouped according to the body system, such as the digestive or urinary system, on which
surgery is performed. The AMA revises the CPT each year to reflect new developments in medical
In 1977, Congress instructed the Health Care Financing Administration ("HCFA") to establish a
uniform code for identifying physicians' services for use in completing Medicare and Medicaid
42 U.S.C. §1395w-4(c)(5). Rather than creating a new code, HCFA contracted
with the AMA to "adopt and use" the CPT. The AMA gave HCFA a "non-exclusive, royalty free,
and irrevocable license to use, copy, publish and distribute" the CPT. In exchange, HCFA agreed
"not to use any other system of procedure nomenclature . . . for reporting physicians' services" and
to require use of the CPT in programs administered by HCFA, by
its agents, and by other
agencies whenever possible.
HCFA published notices in the Federal Register incorporating the CPT in HCFA's Common
Procedure Coding System, and adopted regulations requiring applicants for Medicaid reimburse-
ment to use the CPT.
HCFA had the right to cancel the agreement and use a competing coding system at any time and without penalty on
ninety days notice.