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Location-Based Adjustments (aka GPCIs)

Location-Based Adjustments (aka GPCIs) in effect for CA as of January 1st, 2019

The State of California has added another wrinkle for doctors seeking work comp reimbursements to keep track of. Say hello to “location based adjustments or Geographic Practice Cost Indices (GPCIs)”.

Doctors in many areas will be taking another hit to their net reimbursements, approximately 3 – 4% while in the most expensive locations doctors will receive at least a 10% increase over 2018 reimbursements.

The biggest development is that the California Division of Worker’s Compensation (DWC) updated the Physician Fee Schedule, as of January 1, 2019.

The changes to this fee schedule include the adoption of Medicare Geographic Practice Cost Indices, in 8 CCR § 9789.12.2 (e)(2). These new fee schedules are being used to calculate reimbursement for physician and non-physician services.

Keep a very close eye on your workers comp reimbursements. Practices are reporting underpayments/incorrect reimbursements.

These new GPCIs are adding complexity and confusion to the billing and reimbursement ecosystem. Be prepared to file more appeals.

While Location-based Adjustments are adding complexity MBC Systems can take complexity away. Fill out our handy contact form or call us at (949) 863-0022 to find out more.