Geographic Practice Cost Indices (GPCI)

Understanding the 2019 Value Table

2019 GPCI Value Table

The following table shows the GPCI values, by Medicare Carrier and Locality, CPT® Conversion Factor and Anesthesia Conversion Factor by Locality for 2019. eMDs uses these in conjunction with the RVU values for each CPT® fee to automatically calculate your Medicare fee schedule. This fee schedule can also be copied and adjusted for other contracts based on Medicare. We advise that you check this page at the start of each quarter to see if there have been changes to the conversion factor or GPCIs. You should also check for updated RVU conversion files. Instructions for updating eMDs systems can be found in your system documentation. The 2019 Physician Fee Schedule Conversion Factor is $36.0391.

What Medicare Locality Am I in?

Addendum CY 2019 (GPCIs) by State and Medicare Locality

YOUR RESULTS FROM THE ABOVE SEARCH:

Instructions
  • Ensure you have the 2019 CPT® & HCPCS content update.
  • Ensure you have the 2019 RVU update against the CPT® and HCPCS codes.
  • Look up your Medicare locality in the Locality Name column. Make sure you distinguish between urban areas and rest of state areas.
  • In eMDs Bill, click File >> Setup Options and type the GPCI values into the fields provided. Don’t forget to use the decimal point. Note that the options are facility-specific, so be sure to set these based on the facility in which you are calculating fees. There is no Budget Neutrality Adjuster (BNA) for 2016 so leave the Data 1 field blank or set to 1.
  • Enter the CPT® and Anesthesia Conversion Factors. The 2019 Physician Fee Schedule Conversion Factor is $36.0391 . The anesthesia CF for your locality can be found in the 2019 GPCI Medicare table. Click Save.
  • Refer to Fee Schedules in the eMDs Bill User Guide for assistance with creating the Medicare and other fee schedules.

**Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.
***PE GPCI reflects a 1.0 floor for frontier states established by the ACA.