Additionally, CMS is proposing to adjust this single unit of payment by the Geographic Adjustment Factor (GAF) - a weighted composite of the three geographic practice cost indices
used for the PFS.
Information on hysteroscopic procedures, and their associated RVUs, on geographic practice cost indices
and on pricing, can be accessed using Medicare's Physician Fee Schedule lookup tool (www.cms.gov/apps/ physician-fee-schedule / overview, aspx).
Part 5 presents all elements necessary for calculating the Medicare payment schedule: 2009 relative value units and payment policy indicators for each physician's service, and geographic practice cost indices
(GPCIs) for 2009 for each Medicare payment locality.
Geographic practice cost indices
(GPCIs) are used to raise or lower Medicare physician fees depending on whether local practice costs are above or below the national average.
Gillis, K, Reynolds, R., and Willke, R.: Assessing the Validity of Geographic Practice Cost Indices
Defects in the Geographic Practice Cost Indices
and area designations.
The proposed amendments to the physician fee schedule regulations would eliminate the use of the average statewide geographic adjustment factor and adopt Medicares MSA-based locality-specific geographic adjustment factors, known as the Geographic Practice Cost Indices
(GPCIs), which Medicare implemented effective January 1, 2017.