ADDENDUM D.  PROPOSED CY 2018 GEOGRAPHIC ADJUSTMENT FACTORS (GAFs)*				
Medicare Administrative Contractor	Locality Number	Medicare Locality	2018 GAF 	
10102	00	ALABAMA	0.918	
02102	01	ALASKA**	1.294	
03102	00	ARIZONA	0.97	
07102	13	ARKANSAS	0.91	
01112	54	"BAKERSFIELD, CA"	1.026	
01112	55	"CHICO, CA"	1.025	
01182	71	"EL CENTRO, CA"	1.025	
01112	56	"FRESNO, CA"	1.025	
01112	57	"HANFORD-CORCORAN, CA"	1.025	
01182	18	"LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES CNTY), CA"	1.09	
01182	26	"LOS ANGELES-LONG BEACH-ANAHEIM (ORANGE CNTY), CA"	1.09	
01112	58	"MADERA, CA"	1.025	
01112	59	"MERCED, CA"	1.025	
01112	60	"MODESTO, CA"	1.025	
01112	51	"NAPA, CA"	1.119	
01182	17	"OXNARD-THOUSAND OAKS-VENTURA, CA"	1.077	
01112	61	"REDDING, CA"	1.025	
01112	62	"RIVERSIDE-SAN BERNARDINO-ONTARIO, CA"	1.03	
01112	63	"SACRAMENTO--ROSEVILLE--ARDEN-ARCADE, CA"	1.032	
01112	64	"SALINAS, CA"	1.035	
01182	72	"SAN DIEGO-CARLSBAD, CA"	1.038	
01112	07	"SAN FRANCISCO-OAKLAND-HAYWARD (ALAMEDA/CONTRA COSTA CNTY), CA"	1.159	
01112	52	"SAN FRANCISCO-OAKLAND-HAYWARD (MARIN CNTY), CA"	1.133	
01112	05	"SAN FRANCISCO-OAKLAND-HAYWARD (SAN FRANCISCO CNTY), CA"	1.159	
01112	06	"SAN FRANCISCO-OAKLAND-HAYWARD (SAN MATEO CNTY), CA"	1.159	
01112	65	"SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY), CA"	1.077	
01112	09	"SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY), CA"	1.175	
01182	73	"SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE, CA"	1.027	
01112	66	"SANTA CRUZ-WATSONVILLE, CA"	1.054	
01182	74	"SANTA MARIA-SANTA BARBARA, CA"	1.044	
01112	67	"SANTA ROSA, CA"	1.043	
01112	68	"STOCKTON-LODI, CA"	1.025	
01112	53	"VALLEJO-FAIRFIELD, CA"	1.119	
01112	69	"VISALIA-PORTERVILLE, CA"	1.025	
01112	70	"YUBA CITY, CA"	1.025	
01112	75	REST OF CALIFORNIA	1.025	
04112	01	COLORADO	1.008	
13102	00	CONNECTICUT	1.072	
12202	01	DC + MD/VA SUBURBS	1.126	
12102	01	DELAWARE	1.017	
09102	03	"FORT LAUDERDALE, FL"	1.031	
09102	04	"MIAMI, FL"	1.075	
09102	99	REST OF FLORIDA	0.981	
10202	01	"ATLANTA, GA"	1.001	
10202	99	REST OF GEORGIA	0.948	
01212	01	"HAWAII, GUAM"	1.049	
02202	00	IDAHO	0.916	
06102	16	"CHICAGO, IL"	1.059	
06102	12	"EAST ST. LOUIS, IL"	0.997	
06102	15	"SUBURBAN CHICAGO, IL"	1.053	
06102	99	REST OF ILLINOIS	0.963	
08102	00	INDIANA	0.921	
05102	00	IOWA	0.918	
05202	00	KANSAS	0.926	
15102	00	KENTUCKY	0.925	
07202	01	"NEW ORLEANS, LA"	0.99	
07202	99	REST OF LOUISIANA	0.946	
14112	03	SOUTHERN MAINE	0.979	
14112	99	REST OF MAINE	0.936	
12302	01	"BALTIMORE/SURR. CNTYS, MD"	1.067	
12302	99	REST OF MARYLAND	1.023	
14212	01	"METROPOLITAN BOSTON, MA"	1.1	
14212	99	REST OF MASSACHUSETTS	1.043	
08202	01	"DETROIT, MI"	1.025	
08202	99	REST OF MICHIGAN	0.953	
06202	00	MINNESOTA	0.977	
07302	00	MISSISSIPPI	0.895	
05302	02	"METROPOLITAN KANSAS CITY, MO"	0.978	
05302	01	"METROPOLITAN ST. LOUIS, MO"	0.976	
05302	99	REST OF MISSOURI	0.918	
03202	01	MONTANA***	1.009	
05402	00	NEBRASKA	0.915	
01312	00	NEVADA***	1.005	
14312	40	NEW HAMPSHIRE	1.018	
12402	01	NORTHERN NJ	1.099	
12402	99	REST OF NEW JERSEY	1.065	
04212	05	NEW MEXICO	0.966	
13202	01	"MANHATTAN, NY"	1.134	
13202	02	"NYC SUBURBS/LONG ISLAND, NY"	1.162	
13202	03	"POUGHKPSIE/N NYC SUBURBS, NY"	1.053	
13292	04	"QUEENS, NY"	1.164	
13282	99	REST OF NEW YORK	0.954	
11502	00	NORTH CAROLINA	0.943	
03302	01	NORTH DAKOTA***	0.969	
15202	00	OHIO	0.958	
04312	00	OKLAHOMA	0.929	
02302	01	"PORTLAND, OR"	1.02	
02302	99	REST OF OREGON	0.971	
12502	01	"METROPOLITAN PHILADELPHIA, PA"	1.061	
12502	99	REST OF PENNSYLVANIA	0.968	
09202	20	PUERTO RICO	1.002	
14412	01	RHODE ISLAND	1.036	
11202	01	SOUTH CAROLINA	0.93	
03402	02	SOUTH DAKOTA***	0.954	
10302	35	TENNESSEE	0.923	
04412	31	"AUSTIN, TX"	0.995	
04412	20	"BEAUMONT, TX"	0.951	
04412	09	"BRAZORIA, TX"	1.002	
04412	11	"DALLAS, TX"	1.002	
04412	28	"FORT WORTH, TX"	0.986	
04412	15	"GALVESTON, TX"	1.008	
04412	18	"HOUSTON, TX"	1.013	
04412	99	REST OF TEXAS	0.958	
03502	09	UTAH	0.964	
14512	50	VERMONT	0.979	
11302	00	VIRGINIA	0.986	
09202	50	VIRGIN ISLANDS	1.002	
02402	02	"SEATTLE (KING CNTY), WA"	1.076	
02402	99	REST OF WASHINGTON	0.999	
11402	16	WEST VIRGINIA	0.931	
06302	00	WISCONSIN	0.944	
03602	21	WYOMING***	0.986	
				
GAF equation: (0.50866 * work GPCI) + (0.44839 * PE GPCI) + (0.04295 * MP GPCI).				
				
" * The 1.0 Work GPCI floor required by Section 201 of the MACRA of 2015 expires on December 31, 2017, therefore the Work GPCIs for 2018 do not reflect a 1.0 floor."				
				
**GAF reflects a 1.5 work GPCI floor in Alaska established by the MIPPA.				
***GAF reflects a 1.0 PE GPCI floor for frontier states established by the Affordable Care Act.				
				
 				
