We've noted practices in some areas of the country are facing decreases in their reimbursements because the minimum work geographic practice cost indices (GPCI) of 1.000 expired Jan. 1. Below is a complete list of those locales with work GPCIs below 1.000.
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Work GPCIs dropping below 1.000
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Locality name
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Work GPCI
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Locality name
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Work GPCI
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Alabama
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0.982
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Ohio
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0.993
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Arizona
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0.988
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Oklahoma
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0.964
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Arkansas
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0.961
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Puerto Rico
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0.904
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Austin, Texas
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0.992
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Rest of Florida
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0.973
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Beaumont, Texas
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0.984
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Rest of Georgia
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0.979
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Colorado
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0.986
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Rest of Illinois
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0.975
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East St. Louis, Ill.
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0.989
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Rest of Louisiana
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0.970
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Fort Lauderdale, Fla.
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0.989
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Rest of Maine
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0.962
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Fort Worth, Texas
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0.998
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Rest of Maryland
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0.994
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Galveston, Texas
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0.991
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Rest of Michigan
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0.998
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Hawaii/Guam
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0.998
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Rest of Missouri
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0.949
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Idaho
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0.967
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Rest of New York
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0.997
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Indiana
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0.986
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Rest of Oregon
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0.968
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Iowa
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0.965
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Rest of Pennsylvania
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0.993
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Kansas
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0.969
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Rest of Texas
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0.968
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Kentucky
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0.969
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Rest of Washington
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0.987
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Metro Kansas City, Mo.
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0.990
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South Carolina
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0.975
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Metro St Louis, Mo.
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0.993
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South Dakota
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0.942
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Minnesota
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0.992
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Southern Maine
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0.980
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Mississippi
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0.959
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Tennessee
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0.978
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Montana
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0.950
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Utah
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0.977
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Nebraska
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0.959
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Vermont
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0.968
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New Hampshire
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0.982
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Virgin Islands
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0.997
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New Mexico
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0.973
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Virginia
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0.982
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New Orleans, La.
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0.986
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West Virginia
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0.973
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North Carolina
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0.972
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Wisconsin
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0.988
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North Dakota
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0.947
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Wyoming
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0.956
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Source: CMS, 2010 Physician Fee Schedule
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Work GPCIs are just part of the overall payment formula. There are malpractice GPCIs and physician expense GPCIs, too. But the 1.000 floor only applied to work GPCIs. Here is the payment formula:
[(Work RVU * Work GPCI) +(Transitioned Non-Facility PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor (CF) = Your payment $
So, just as one example, Kansas's work GPCI is 0.969, instead of the minimum 1.000. A 99213 (office, outpatient, est.) in Kansas would be calculated like this:
[(0.97*0.969) +(0.80 * 0.882) + (0.05 * 0.557)] * $36.0846 = $60.38
If the GPCI work floor was 1.000, then payment would be $61.47, which would be an increase of about 1.8%.