Locale-Specific Medicare Anesthesia Conversion Factors to Increase in Some Areas

The Further Consolidated Appropriations Act of 2020 (FCAA) as passed by Congress and signed by President Trump in late December provides funding for several health care extenders including a floor of 1.00 for the work Geographic Practice Cost Index (GPCI).  The work, practice expense and professional liability insurance GPCIs play an important role in determining Medicare payment amounts for services paid through the Medicare Physician Fee Schedule (MPFS).

For anesthesia services, this means that for those locales where the work GPCI would have fallen below 1.00 without this FCAA provision, the locale-specific Medicare anesthesia conversion factor will increase from the figures that were released in October when the Centers for Medicare & Medicare Services (CMS) released its Final Rule for the 2020 MPFS.  Those in impacted locales will also see increases to the payment for the non-anesthesia services they provide.  

The CY 2020  locale-specific Medicare anesthesia conversion factors as updated December 20, 2019 are available here.

The Medicare Administrative Contractors (MACs) are updating their fee schedules to reflect these changes.  The FCAA extension of the work GPCI floor will continue through May 22, 2020.  Additional Congressional action will be required to extend the GPCIs through the end of the year. 

Impact Localities are:

Contractor	Locality		Locality Name
10112	00		ALABAMA
03102	00		ARIZONA
07102	13		ARKANSAS
09102	03		FORT LAUDERDALE
09102	04		MIAMI
09102	99		REST OF FLORIDA
10212	99		REST OF GEORGIA
02202	00		IDAHO
06102	12		EAST ST. LOUIS
06102	99		REST OF ILLINOIS
08102	00		INDIANA
05102	00		IOWA
05202	00		KANSAS
15102	00		KENTUCKY
07202	01		NEW ORLEANS
07202	99		REST OF LOUISIANA
14112	03		SOUTHERN MAINE
14112	99		REST OF MAINE
08202	01		DETROIT
08202	99		REST OF MICHIGAN
07302	00		MISSISSIPPI
05302	02		METROPOLITAN KANSAS CITY
05302	01		METROPOLITAN ST. LOUIS
05302	99		REST OF MISSOURI
03202	01		MONTANA***
05402	00		NEBRASKA
14312	40		NEW HAMPSHIRE
04212	05		NEW MEXICO
13282	99		REST OF NEW YORK
11502	00		NORTH CAROLINA
03302	01		NORTH DAKOTA***
15202	00		OHIO
04312	00		OKLAHOMA
02302	99		REST OF OREGON
12502	99		REST OF PENNSYLVANIA
09202	20		PUERTO RICO
11202	01		SOUTH CAROLINA
03402	02		SOUTH DAKOTA***
10312	35		TENNESSEE
04412	20		BEAUMONT
04412	99		REST OF TEXAS
03502	09		UTAH
14512	50		VERMONT
11302	00		VIRGINIA
09202	50		VIRGIN ISLANDS
02402	02		SEATTLE (KING CNTY)
02402	99		REST OF WASHINGTON
11402	16		WEST VIRGINIA
06302	00		WISCONSIN
03602	21		WYOMING***