This video in DaisyBill’s Essential Basics Explained series provides information about the 2019 adoption of Geographic Practice Cost Indices (GPCIs) by the California Division of Workers’ Compensation (DWC) to calculate reimbursements for services covered by the Physician Services Fee Schedule.
Video Summary
This video demystifies important changes to the 2019 Physician Fee Schedule, focusing primarily on Geographic Practice Cost Indices (GPCIs). Learn all about GPCIs and what this change means for workers’ comp reimbursements in California. The video highlights adjustments to the formula for calculating Base Maximum Fees and includes a demonstration of how DaisyBill’s OMFS Calculator manages this complicated process.
Geographic Practice Cost Indices
The 2019 Physician Fee Schedule requires use of GPCIs for reimbursement calculations for dates of service on or after January 1, 2019. The Geographic Practice Cost Index, as defined by the DWC, adjusts reimbursements “by locality corresponding to the county where service was provided.” This means that all bills will be adjusted based on the site of service’s county or ZIP code and it is now very important that independent bills are filed from every service location because costs vary by are
Base Maximum Fee Calculation
According to CCR § 9789.12.2, the RBRVS requires use of the Geographic Practice Cost Index (GPCI) for dates of service on or after January 1, 2019.
This means that the formula for calculating the Base Maximum Fee changes for 2019 services. GPCIs are one of the three separate components the formula requires to be calculated:
- Relative Value Units (RVUs)
- Geographic Practice Cost Index (GPCIs)
- Conversion Factor (CF)
For a complete outline of how to apply the Base Maximum Fee Formula, read our article Reimbursement for Physician Services Rendered on or After January 1, 2019.
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