Geographic Practice Cost Index GPCI

$179 / year

This dataset provides each Geographic Practice Cost Index (GPCI) component for each carrier/locality for 2017, 2018 and 2019. 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.

Complexity

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)

Date Created

2015-05-28

Last Modified

2018-12-20

Version

2018-12-20

Update Frequency

Quarterly

Temporal Coverage

2018-07 to 2018-12

Spatial Coverage

United States

Source

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

GPCI 2019, Geographic Practice Cost Index 2019, Physician Fee Schedule 2019, GPCI 2018, Geographic Practice Cost Index 2018, Physician Fee Schedule 2018

Other Titles

Physicians Fee Schedule Locality Structure 2017-2019, Geographic Classification for Practice Expense (PE) 2017-2019

NameDescriptionTypeConstraints
YearYear of Geographic Practice Cost Index GPCI (2017, 2018 and 2019)date-
CarrierCarrier Code.integerlevel : Nominal
Locality_CodeLocality Code locality to which the fee schedule amount appliesintegerlevel : Nominal
Locality_NameName of the Locality to which the fee schedule amount appliesstring-
State_AbbreviationState abbreviation of the locality namestring-
Work_GPCIGeographic classification values for work according to Localities.numberlevel : Ratio
PE_GPCIGeographic classification values for Practice Expense (PE) according to Localities.numberlevel : Ratio
MP_GPCIGeographic classification values for Malpractice (MP) according to Localities.numberlevel : Ratio
YearCarrierLocality_CodeLocality_NameState_AbbreviationWork_GPCIPE_GPCIMP_GPCI
201722020IDAHO10.90.51
201732021MONTANA111.429
2017360221WYOMING111.05
201932021MONTANA111.631
2019360221WYOMING110.88
201751020IOWA10.9020.458
201735029UTAH10.9251.167
201951020IOWA10.9070.423
201935029UTAH10.9271.165
2017152020OHIO10.9180.999