Skip to Main Content

Medicare PFS Locality Configuration and Studies

Interim Study of Alternative Payment Localities under the PFS

Medicare is statutorily required to adjust payments for physician fee schedule services to account for differences in costs due to geographic location. At this time we are not proposing to make any changes to the payment localities. We accepted comments on the options presented in the interim report as well as suggestions for other options until November 3, 2008. We will summarize all comments received on the interim locality study report in future rulemaking.

These comments will be considered in the development of possible future notice and comment rulemaking. When we are ready to propose any changes to the locality configuration, we will provide extensive opportunities for public comment (for example, a town hall meeting or open door forum) on specific proposals before implementing any change.

Interim report: “ Review of Alternative Geographic Practice Cost Index (GPCI) Payment Locality Structures Report [PDF, 1MB] ”, appendices and master data file.

Review of Alternative GPCI Payment Locality Structures - Final Report

The report titled “Review of Alternative GPCI Payment Locality Structures-Final Report” finalizes the interim locality study that was originally posted to the website on August 21, 2008.

At this time we are not proposing to make any changes to the payment localities.  We are posting this final report to finalize the information contained in our interim study of alternative PFS locality payment configurations.  For a detailed discussion of the public comments on the contractor's interim locality study report, we refer readers to the CY 2010 PFS proposed rule (74 FR 33534) and subsequent final rule with comment period (74 FR 61757).

Final report: " Review of Alternative GPCI Payment Locality Structures-Final Report [PDF, 2MB] " and appendices

Geographic Adjustment of Medicare Payments to Physicians: Evaluation of IOM Recommendations

Concurrent with our CY 2012 rulemaking cycle, the Institute of Medicine released the final version of its report entitled “Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy, Second Edition” on September 28, 2011. This report included an evaluation of the accuracy of geographic adjustment factors for the hospital wage index and the GPCIs, as well as the methodology and data used to calculate them. Several of the policies that we finalized in CY 2012 rulemaking addressed many of the recommendations contained in the Institute of Medicine's report. 

Analysis: " Geographic Adjustment of Medicare Payments to Physicians: Evaluation of IOM Recommendations [PDF, 2MB] "

.