Others titles
- Physicians Fee Schedule Locality Structure 2018-2023
- Geographic Classification for Practice Expense (PE) 2018-2023
Keywords
- GPCI 2023
- Geographic Practice Cost Index 2023
- Physician Fee Schedule 2023
- GPCI 2022
- Geographic Practice Cost Index 2022
- Physician Fee Schedule 2022
- GPCI 2021
- Geographic Practice Cost Index 2021
- Physician Fee Schedule 2021
Geographic Practice Cost Index GPCI
This dataset provides each Geographic Practice Cost Index (GPCI) component for each carrier/locality for 2020, 2021, 2022 and 2023. To calculate the payment for every physician’s service, more information, the components of the fee schedule (physician work and MP RVUs – Medical Physicians Relative Value Unit) are adjusted by a GPCI.
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Description
The Medicare physician fee schedule amounts are adjusted to reflect the variation in practice costs from area to area. A geographic practice cost index (GPCI) has been established for every Medicare payment locality for each of the three components of a procedure’s relative value unit (i.e., the RVUs for work, practice expense, and malpractice). The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.
Geographic Practice Cost Index is used along with Relative Value Units by Medicare to determine allowable payment amounts for medical procedures. There are multiple GPCIs: Cost of Living, Malpractice, and Practice Cost/Expense. These categories allow Medicare to adjust reimbursement rates to take into account regional and practice-specific factors. The GPCIs reflect the relative costs of physician work, practice expense, and malpractice expense in a specific area compared to the national average costs for each component.
An example calculation for a Medicare allowed amount is:
2009 Non-Facility Pricing Amount = [(Work RVU * Work GPCI) + (Transitioned Non-Facility PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor (CF)
About this Dataset
Data Info
Date Created | 2015-05-28 |
---|---|
Last Modified | 2023-06-14 |
Version | 2023-06-14 |
Update Frequency |
Quarterly |
Temporal Coverage |
2020 to 2023 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers of Medicare and Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | GPCI 2023, Geographic Practice Cost Index 2023, Physician Fee Schedule 2023, GPCI 2022, Geographic Practice Cost Index 2022, Physician Fee Schedule 2022, GPCI 2021, Geographic Practice Cost Index 2021, Physician Fee Schedule 2021 |
Other Titles | Physicians Fee Schedule Locality Structure 2018-2023, Geographic Classification for Practice Expense (PE) 2018-2023 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Year | Year of Geographic Practice Cost Index GPCI (2020 to 2023) | date | - |
Carrier | Carrier Code. | integer | level : Nominal |
Locality_Code | Locality Code locality to which the fee schedule amount applies | string | - |
Locality_Name | Name of the Locality to which the fee schedule amount applies | string | - |
State_Abbreviation | State abbreviation of the locality name | string | - |
Work_GPCI | Geographic classification values for work according to Localities. | number | level : Ratio |
PE_GPCI | Geographic classification values for Practice Expense (PE) according to Localities. | number | level : Ratio |
MP_GPCI | Geographic classification values for Malpractice (MP) according to Localities. | number | level : Ratio |
Data Preview
Year | Carrier | Locality Code | Locality Name | State Abbreviation | Work GPCI | PE GPCI | MP GPCI |
2020 | 10112 | 1 | ALABAMA | 1.0 | 0.9 | 0.7 | |
2020 | 2102 | 0 | ALASKA | 1.5 | 1.1 | 0.7 | |
2020 | 3102 | 13 | ARIZONA | 1.0 | 1.0 | 0.8 | |
2020 | 7102 | 54 | ARKANSAS | 1.0 | 0.9 | 0.5 | |
2020 | 1112 | 55 | BAKERSFIELD | 1.0 | 1.1 | 0.7 | |
2020 | 1112 | 71 | CHICO | 1.0 | 1.1 | 0.6 | |
2020 | 1182 | 56 | EL CENTRO | 1.0 | 1.1 | 0.6 | |
2020 | 1112 | 57 | FRESNO | 1.0 | 1.1 | 0.6 | |
2020 | 1112 | 18 | HANFORD-CORCORAN | 1.0 | 1.1 | 0.6 | |
2020 | 1182 | 26 | LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES CNTY) | 1.0 | 1.2 | 0.7 |