Locality County Crosswalk

$179 / year

This dataset shows the 2017, 2018 and 2019 Locality County Crosswalk. Data includes 52 localities in the other 16 states, with 10 states having 2 localities, 2 states having 3 localities, 1 state having 4 localities, and 3 states have 5 or more localities.

Complexity

The current Physician Fee Schedule (PFS) locality structure was developed and implemented in 1997. There are currently 89 total PFS localities; 34 localities are statewide areas (that is, only one locality for the entire state). The District of Columbia, Maryland, and Virginia suburbs, Puerto Rico, and the Virgin Islands are additional localities that make up the remainder of the total of 89 localities.

On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA 2014) was signed into law and Section 220(h) of the legislation adds section 1848(e)(6) of the Act, which now requires, for services furnished on or after January 1, 2017, that the locality definitions for California be based on the Metropolitan Statistical Area (MSA) delineations as defined by the Office of Management and Budget (OMB). The resulting modifications to California’s locality structure increase its number of localities from 9 under the current locality structure to 27 under the MSA based locality structure (operational note: for the purposes of payment the actual number of localities under the MSA-based locality structure would be 32). Additionally, for some of these new localities, PAMA requires that the GPCI values that would be realized under the new MSA based locality structure are gradually phased in (in one-sixth increments) over a period of 6 years.

Date Created

2015-05-28

Last Modified

2020-01-31

Version

2020-01-31

Update Frequency

Quarterly

Temporal Coverage

2017-2020

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Part B Provider, Medicare Fee Schedule, Medicare Locality, Medicare Locality Codes, Medicare Payment, Locality Number

Other Titles

Physicians Fee Schedule Locality Structure, Medicare PFS Locality, PFS Locality County Crosswalk 2019, PFS Locality County Crosswalk 2018, PFS Locality County Crosswalk 2017

NameDescriptionTypeConstraints
YearYear of Locality County Crosswalk (2017, 2018 and 2019)date-
Carrier_CodeA number assigned to a specific carrier.integerlevel : Nominal
Locality_CodeA number assigned to a specific locality.integerlevel : Nominal
StateState Namestring-
Fee_Schedule_AreaListing of fees used by Medicare to pay doctors or other providers/suppliers according to area.string-
CountiesCounty name.string-
YearCarrier CodeLocality CodeStateFee Schedule AreaCounties
2017101020ALABAMASTATEWIDEALL COUNTIES
201721021ALASKASTATEWIDEALL COUNTIES
201731020ARIZONASTATEWIDEALL COUNTIES
2017710213ARKANSASSTATEWIDEALL COUNTIES
2017118226CALIFORNIALOS ANGELES-LONG BEACH-ANAHEIM (ORANGE CNTY)ORANGE
2017118218LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES CNTY)LOS ANGELES
2017111252SAN FRANCISCO-OAKLAND-HAYWARD (MARIN CNTY)MARIN
201711127OAKLAND/BERKLEYALAMEDA AND CONTRA COSTA
201711125SAN FRANCISCOSAN FRANCISCO
201711126SAN MATEOSAN MATEO