GPCI

GPCI

2013 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 2013. e-MDs Bill 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 the for updated RVU conversion files.

Instructions:

  1. Ensure you have the 2013 CPT® & HCPCS content update.
  2. Ensure you have the 2013 RVU update against the CPT® and HCPCS codes.
  3. Look up your Medicare locality in the Locality Name column. Make sure you distinguish between urban areas and rest of state areas.
  4. In e-MDs 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 2013 so leave the Data 1 field blank or set to 1.
  5. Enter the CPT® and Anesthesia Conversion Factors. The 2013 Physician Fee Schedule Conversion Factor is $34.0230 . The anesthesia CF for your locality can be found in the GPCI table. Click Save.
  6. Refer to Fee Schedules in the e-MDs Bill User Guide for assistance with creating the Medicare and other fee schedules.

 

 

ADDENDUM E FINAL 2013 GEOGRAPHIC PRACTICE COST INDICES (GPCIs)
Locality Locality Name  2013    Work GPCI  2013        PE GPCI  2013 MP     GPCI  Anes. CF
00 Alabama 1.000 0.878 0.474 20.50
01 Alaska ** 1.500 1.067 0.661 29.76
00 Arizona 1.000 0.978 1.015 21.87
13 Arkansas 1.000 0.865 0.450 2041
26 Anaheim/Santa Ana, CA 1.044 1.218 0.676 22.82
18 Los Angeles, CA 1.036 1.154 0.642 22.40
03 Marin/Napa/Solano, CA 1.051 1.248 0.456 22.63
07 Oakland/Berkeley, CA 1.058 1.254 0.516 22.88
99 Rest of California 1.024 1.085 0.547 21.77
05 San Francisco, CA 1.072 1.360 0.516 23.49
06 San Mateo, CA 1.072 1.354 0.516 23.47
09 Santa Clara, CA 1.077 1.337 0.516 23.49
17 Ventura, CA 1.034 1.193 0.605 22.44
01 Colorado 1.000 1.004 0.872 21.70
00 Connecticut 1.024 1.110 1.235 23.15
01 DC + MD/VA Suburbs 1.049 1.198 1.130 23.68
01 Delaware 1.012 1.044 0.672 21.66
03 Fort Lauderdale, FL 1.000 1.051 1.982 23.95
04 Miami, FL 1.000 1.054 2.815 25.52
99 Rest of Florida 1.000 0.968 1.553 22.85
01 Atlanta, GA 1.002 1.015 0.949 21.92
99 Rest of Georgia 1.000 0.898 0.928 21.42
01 Hawaii/Guam/American Samoa/Northern Mariana Islands 1.000 1.154 0.700 21.91
00 Idaho 1.000 0.894 0.603 20.80
16 Chicago, IL 1.030 1.051 2.077 24.62
12 East St. Louis, IL 1.000 0.936 1.934 23.45
99 Rest of Illinois 1.000 0.909 1.336 22.23
15 Suburban Chicago, IL 1.025 1.072 1.706 23.92
00 Indiana 1.000 0.923 0.613 20.92
00 Iowa 1.000 0.887 0.456 20.50
00 Kansas 1.000 0.894 0.957 21.46
00 Kentucky 1.000 0.871 0.752 21.00
01 New Orleans, LA 1.000 0.976 0.921 21.69
99 Rest of Louisiana 1.000 0.877 0.744 21.00
99 Rest of Maine 1.000 0.904 0.676 20.97
03 Southern Maine 1.000 1.024 0.676 21.40
01 Baltimore/Surr. Cntys, MD 1.027 1.097 1.206 23.10
99 Rest of Maryland 1.011 1.035 0.987 22.21
01 Metropolitan Boston 1.014 1.149 0.790 22.30
99 Rest of Massachusetts 1.013 1.062 0.790 21.97
01 Detroit, MI 1.022 1.023 1.814 23.89
99 Rest of Michigan 1.000 0.923 1.069 21.78
00 Minnesota 1.000 1.012 0.282 20.62
00 Mississippi 1.000 0.866 0.761 21.00
02 Metropolitan Kansas City, MO 1.000 0.953 1.233 22.19
01 Metropolitan St Louis, MO 1.000 0.964 1.064 21.92
99 Rest of Missouri 1.000 0.851 1.023 21.43
01 Montana *** 1.000 1.000 1.103 22.12
00 Nebraska 1.000 0.904 0.322 20.31
00 Nevada *** 1.000 1.058 1.232 22.57
40 New Hampshire 1.000 1.044 0.860 21.82
01 Northern NJ 1.044 1.186 1.045 23.40
99 Rest of New Jersey 1.021 1.126 1.045 22.81
05 New Mexico 1.000 0.916 0.997 21.62
01 Manhattan, NY 1.062 1.162 1.271 24.03
02 NYC Suburbs/Long I., NY 1.049 1.212 1.441 24.32
03 Poughkpsie/N NYC Suburbs, NY 1.011 1.065 1.081 22.49
04 Queens, NY 1.062 1.195 1.491 24.56
99 Rest of New York 1.000 0.939 0.562 20.88
00 North Carolina 1.000 0.927 0.695 21.09
01 North Dakota *** 1.000 1.000 0.517 21.02
00 Ohio 1.000 0.927 1.240 22.11
00 Oklahoma 1.000 0.856 0.734 20.91
01 Portland, OR 1.005 1.044 0.625 21.46
99 Rest of Oregon 1.000 0.962 0.625 21.09
01 Metropolitan Philadelphia, PA 1.014 1.059 1.624 23.54
99 Rest of Pennsylvania 1.000 0.913 1.123 21.84
20 Puerto Rico 1.000 0.678 0.249 19.36
01 Rhode Island 1.017 1.052 1.187 22.74
01 South Carolina 1.000 0.909 0.520 20.70
02 South Dakota *** 1.000 1.000 0.432 20.86
35 Tennessee 1.000 0.898 0.523 20.66
31 Austin, TX 1.000 1.009 0.751 21.49
20 Beaumont, TX 1.000 0.896 0.923 21.41
09 Brazoria, TX 1.009 0.987 0.923 21.88
11 Dallas, TX 1.009 1.017 0.834 21.82
28 Fort Worth, TX 1.000 0.979 0.826 21.52
15 Galveston, TX 1.009 0.996 0.985 22.03
18 Houston, TX 1.009 1.002 0.923 21.94
99 Rest of Texas 1.000 0.912 0.809 21.25
09 Utah 1.000 0.916 1.102 21.81
50 Vermont 1.000 1.008 0.554 21.12
50 Virgin Islands 1.000 1.002 1.010 21.95
00 Virginia 1.000 0.977 0.731 21.34
99 Rest of Washington 1.000 1.012 0.861 21.71
02 Seattle (King Cnty), WA 1.025 1.144 0.881 22.63
16 West Virginia 1.000 0.828 1.229 21.74
00 Wisconsin 1.000 0.960 0.547 20.93
21 Wyoming *** 1.000 1.000 1.233 22.36