ADDENDUM  E. PROPOSED 2020 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY*																						
Medicare Administrative Contractor	State	Locality Number	Locality Name	2019			2020			2021												
				PW GPCI*     (with 1.0 Floor)	PE GPCI	MP GPCI	PW GPCI 	PE GPCI	MP GPCI	PW GPCI 	PE GPCI	MP GPCI										
10112	AL	00	ALABAMA	1.000	0.890	0.492	0.985	0.902	0.700	0.970	0.913	0.908										
02102	AK	01	ALASKA**	1.500	1.117	0.708	1.500	1.099	0.663	1.500	1.081	0.618										
03102	AZ	00	ARIZONA	1.000	0.971	0.834	0.991	0.963	0.849	0.982	0.955	0.863										
07102	AR	13	ARKANSAS	1.000	0.872	0.576	0.976	0.878	0.522	0.953	0.885	0.468										
01112	CA	54	BAKERSFIELD	1.020	1.074	0.618	1.034	1.054	0.680	1.035	1.054	0.701										
01112	CA	55	CHICO	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01182	CA	71	EL CENTRO	1.020	1.074	0.570	1.028	1.054	0.609	1.028	1.054	0.613										
01112	CA	56	FRESNO	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	57	HANFORD-CORCORAN	1.021	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01182	CA	18	LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES CNTY)	1.046	1.177	0.694	1.050	1.163	0.723	1.053	1.148	0.753										
01182	CA	26	LOS ANGELES-LONG BEACH-ANAHEIM (ORANGE CNTY)	1.046	1.177	0.694	1.039	1.187	0.723	1.032	1.198	0.752										
01112	CA	58	MADERA	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	59	MERCED	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	60	MODESTO	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	51	NAPA	1.055	1.256	0.458	1.045	1.168	0.501	1.045	1.168	0.501										
01112	CA	07	OAKLAND/BERKELEY	1.075	1.325	0.421	1.068	1.274	0.440	1.062	1.223	0.459										
01182	CA	17	OXNARD-THOUSAND OAKS-VENTURA	1.024	1.176	0.673	1.026	1.166	0.698	1.028	1.156	0.723										
01112	CA	61	REDDING	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	62	RIVERSIDE-SAN BERNARDINO-ONTARIO	1.021	1.074	0.753	1.028	1.054	0.832	1.028	1.054	0.892										
01112	CA	63	SACRAMENTO--ROSEVILLE--ARDEN-ARCADE	1.027	1.092	0.562	1.035	1.066	0.594	1.037	1.069	0.594										
01112	CA	64	SALINAS	1.026	1.101	0.562	1.052	1.086	0.594	1.059	1.095	0.594										
01182	CA	72	SAN DIEGO-CARLSBAD	1.023	1.116	0.570	1.034	1.115	0.610	1.036	1.130	0.613										
01112	CA	05	SAN FRANCISCO	1.075	1.325	0.421	1.089	1.348	0.440	1.102	1.371	0.459										
01112	CA	52	SAN FRANCISCO-OAKLAND-HAYWARD (MARIN CNTY)	1.065	1.291	0.458	1.049	1.228	0.501	1.050	1.244	0.501										
01112	CA	65	SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY)	1.052	1.214	0.562	1.073	1.133	0.594	1.084	1.152	0.594										
01182	CA	73	SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE	1.020	1.084	0.562	1.028	1.068	0.594	1.028	1.071	0.594										
01112	CA	06	SAN MATEO	1.075	1.325	0.421	1.089	1.362	0.419	1.102	1.398	0.418										
01112	CA	09	SANTA CLARA	1.083	1.354	0.388	1.089	1.342	0.400	1.096	1.330	0.411										
01112	CA	66	SANTA CRUZ-WATSONVILLE	1.030	1.161	0.562	1.040	1.123	0.594	1.043	1.140	0.594										
01182	CA	74	SANTA MARIA-SANTA BARBARA	1.032	1.126	0.562	1.037	1.114	0.594	1.039	1.129	0.594										
01112	CA	67	SANTA ROSA	1.024	1.130	0.562	1.039	1.112	0.594	1.042	1.127	0.594										
01112	CA	68	STOCKTON-LODI	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	53	VALLEJO-FAIRFIELD	1.055	1.256	0.458	1.045	1.168	0.501	1.045	1.168	0.501										
01112	CA	69	VISALIA-PORTERVILLE	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	70	YUBA CITY	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
01112	CA	75	REST OF CALIFORNIA	1.020	1.074	0.562	1.028	1.054	0.594	1.028	1.054	0.594										
04112	CO	01	COLORADO	1.000	1.018	1.042	1.001	1.030	0.906	1.002	1.043	0.770										
13102	CT	00	CONNECTICUT	1.021	1.112	1.255	1.029	1.100	1.086	1.037	1.087	0.916										
12202	DC	01	DC + MD/VA SUBURBS	1.045	1.205	1.261	1.050	1.212	1.282	1.054	1.219	1.303										
12102	DE	01	DELAWARE	1.007	1.019	1.119	1.007	1.020	1.017	1.006	1.021	0.914										
09102	FL	03	FORT LAUDERDALE	1.000	1.012	1.797	0.990	1.007	1.840	0.980	1.002	1.883										
09102	FL	04	MIAMI	1.000	1.029	2.566	0.993	1.024	2.616	0.986	1.019	2.666										
09102	FL	99	REST OF FLORIDA	1.000	0.952	1.358	0.985	0.951	1.405	0.971	0.950	1.451										
10212	GA	01	ATLANTA	1.000	0.997	1.088	1.000	1.000	0.996	1.000	1.003	0.903										
10212	GA	99	REST OF GEORGIA	1.000	0.899	1.073	0.988	0.906	0.988	0.975	0.912	0.903										
01212	HI	01	"HAWAII, GUAM"	1.001	1.146	0.614	1.006	1.134	0.647	1.011	1.122	0.679										
02202	ID	00	IDAHO	1.000	0.902	0.512	0.978	0.903	0.464	0.955	0.904	0.416										
06102	IL	16	CHICAGO	1.008	1.034	1.925	1.010	1.033	1.908	1.012	1.032	1.890										
06102	IL	12	EAST ST. LOUIS	1.000	0.936	1.785	0.993	0.938	1.733	0.987	0.941	1.680										
06102	IL	15	SUBURBAN CHICAGO	1.009	1.053	1.565	1.008	1.051	1.543	1.007	1.049	1.520										
06102	IL	99	REST OF ILLINOIS	1.000	0.919	1.208	0.988	0.924	1.201	0.976	0.928	1.195										
08102	IN	00	INDIANA	1.000	0.919	0.379	0.982	0.918	0.423	0.965	0.918	0.466										
05102	IA	00	IOWA	1.000	0.907	0.423	0.984	0.915	0.417	0.968	0.922	0.411										
05202	KS	00	KANSAS	1.000	0.911	0.615	0.982	0.919	0.530	0.964	0.926	0.445										
15102	KY	00	KENTUCKY	1.000	0.880	0.819	0.985	0.887	0.824	0.970	0.894	0.830										
07202	LA	01	NEW ORLEANS	1.000	0.966	1.273	0.989	0.949	1.359	0.978	0.933	1.445										
07202	LA	99	REST OF LOUISIANA	1.000	0.887	1.199	0.982	0.895	1.218	0.963	0.903	1.236										
14112	ME	03	SOUTHERN MAINE	1.000	1.007	0.670	0.996	1.001	0.662	0.992	0.995	0.654										
14112	ME	99	REST OF MAINE	1.000	0.922	0.670	0.982	0.920	0.662	0.964	0.919	0.654										
12302	MD	01	BALTIMORE/SURR. CNTYS	1.023	1.095	1.295	1.026	1.088	1.314	1.029	1.082	1.332										
12302	MD	99	REST OF MARYLAND	1.009	1.033	1.082	1.010	1.038	1.084	1.012	1.043	1.086										
14212	MA	01	METROPOLITAN BOSTON	1.033	1.179	1.061	1.041	1.181	0.948	1.050	1.183	0.834										
14212	MA	99	REST OF MASSACHUSETTS	1.020	1.067	1.061	1.023	1.060	0.948	1.027	1.053	0.834										
08202	MI	01	DETROIT	1.000	0.989	1.691	0.995	0.990	1.648	0.990	0.990	1.606										
08202	MI	99	REST OF MICHIGAN	1.000	0.919	1.018	0.986	0.922	0.992	0.972	0.925	0.965										
06202	MN	00	MINNESOTA	1.000	1.011	0.362	1.000	1.010	0.356	0.999	1.008	0.349										
07302	MS	00	MISSISSIPPI	1.000	0.870	0.370	0.978	0.875	0.524	0.957	0.880	0.677										
05302	MO	02	METROPOLITAN KANSAS CITY	1.000	0.963	1.073	0.991	0.958	0.980	0.982	0.953	0.886										
05302	MO	01	METROPOLITAN ST. LOUIS	1.000	0.959	1.053	0.995	0.965	0.969	0.989	0.971	0.885										
05302	MO	99	REST OF MISSOURI	1.000	0.863	0.993	0.978	0.876	0.908	0.955	0.889	0.824										
03202	MT	01	MONTANA***	1.000	1.000	1.631	0.974	1.000	1.301	0.949	1.000	0.971										
05402	NE	00	NEBRASKA	1.000	0.910	0.318	0.986	0.916	0.275	0.972	0.922	0.233										
01312	NV	00	NEVADA***	1.002	1.017	0.909	1.004	1.009	1.137	1.007	1.000	1.365										
14312	NH	40	NEW HAMPSHIRE	1.000	1.045	1.050	0.999	1.040	0.987	0.999	1.035	0.923										
12402	NJ	01	NORTHERN NJ	1.041	1.180	0.938	1.045	1.180	0.945	1.050	1.181	0.953										
12402	NJ	99	REST OF NEW JERSEY	1.024	1.123	0.938	1.030	1.124	0.945	1.037	1.124	0.953										
04212	NM	05	NEW MEXICO	1.000	0.921	1.247	0.990	0.921	1.209	0.979	0.922	1.171										
13202	NY	01	MANHATTAN	1.052	1.180	1.615	1.054	1.182	1.818	1.056	1.184	2.021										
13202	NY	02	NYC SUBURBS/LONG ISLAND	1.041	1.205	2.149	1.044	1.201	2.421	1.047	1.196	2.692										
13202	NY	03	POUGHKPSIE/N NYC SUBURBS	1.016	1.070	1.313	1.022	1.081	1.476	1.027	1.091	1.639										
13292	NY	04	QUEENS	1.052	1.200	2.121	1.054	1.204	2.386	1.056	1.208	2.651										
13282	NY	99	REST OF NEW YORK	1.000	0.950	0.595	0.995	0.953	0.670	0.991	0.957	0.745										
11502	NC	00	NORTH CAROLINA	1.000	0.931	0.695	0.989	0.937	0.756	0.978	0.942	0.818										
03302	ND	01	NORTH DAKOTA***	1.000	1.000	0.540	0.985	1.000	0.477	0.970	1.000	0.414										
15202	OH	00	OHIO	1.000	0.917	1.005	0.992	0.919	1.057	0.984	0.922	1.110										
04312	OK	00	OKLAHOMA	1.000	0.891	0.954	0.979	0.895	0.869	0.959	0.899	0.784										
02302	OR	01	PORTLAND	1.010	1.054	0.783	1.016	1.051	0.661	1.023	1.049	0.539										
02302	OR	99	REST OF OREGON	1.000	0.967	0.783	0.993	0.959	0.661	0.985	0.952	0.539										
12502	PA	01	METROPOLITAN PHILADELPHIA	1.022	1.074	1.379	1.022	1.068	1.293	1.023	1.062	1.206										
12502	PA	99	REST OF PENNSYLVANIA	1.000	0.936	1.033	0.993	0.941	0.962	0.987	0.945	0.891										
09202	PR	20	PUERTO RICO	1.000	1.007	0.990	1.000	1.020	0.989	1.000	1.032	0.987										
14412	RI	01	RHODE ISLAND	1.027	1.050	0.999	1.024	1.042	1.130	1.021	1.033	1.260										
11202	SC	01	SOUTH CAROLINA	1.000	0.912	0.553	0.985	0.918	0.624	0.970	0.924	0.695										
03402	SD	02	SOUTH DAKOTA***	1.000	1.000	0.389	0.976	1.000	0.359	0.951	1.000	0.330										
10312	TN	35	TENNESSEE	1.000	0.901	0.526	0.987	0.905	0.507	0.973	0.909	0.489										
04412	TX	31	AUSTIN	1.000	1.021	0.747	1.001	1.035	0.645	1.001	1.048	0.544										
04412	TX	20	BEAUMONT	1.000	0.924	0.839	0.995	0.937	0.697	0.989	0.950	0.555										
04412	TX	09	BRAZORIA	1.020	0.997	0.839	1.026	1.002	0.697	1.032	1.008	0.555										
04412	TX	11	DALLAS	1.012	1.014	0.768	1.018	1.017	0.659	1.024	1.020	0.550										
04412	TX	28	FORT WORTH	1.007	0.986	0.747	1.012	0.991	0.645	1.016	0.996	0.544										
04412	TX	15	GALVESTON	1.020	1.011	0.839	1.026	1.011	0.697	1.032	1.011	0.555										
04412	TX	18	HOUSTON	1.020	1.012	0.936	1.026	1.013	0.924	1.032	1.014	0.912										
04412	TX	99	REST OF TEXAS	1.000	0.938	0.796	0.996	0.953	0.693	0.993	0.968	0.589										
03502	UT	09	UTAH	1.000	0.927	1.165	0.986	0.932	0.976	0.972	0.937	0.787										
14512	VT	50	VERMONT	1.000	1.015	0.595	0.992	1.005	0.581	0.983	0.994	0.568										
11302	VA	00	VIRGINIA	1.000	0.986	0.908	1.000	0.993	0.904	1.000	1.001	0.901										
09202	VI	50	VIRGIN ISLANDS	1.000	1.007	0.990	1.000	1.020	0.989	1.000	1.032	0.987										
02402	WA	02	SEATTLE (KING CNTY)	1.027	1.146	0.931	1.032	1.155	0.859	1.036	1.163	0.787										
02402	WA	99	REST OF WASHINGTON	1.000	1.011	0.902	1.000	1.006	0.828	0.999	1.002	0.753										
11402	WV	16	WEST VIRGINIA	1.000	0.857	1.296	0.981	0.874	1.251	0.961	0.891	1.205										
06302	WI	00	WISCONSIN	1.000	0.957	0.347	0.990	0.951	0.317	0.981	0.944	0.288										
03602	WY	21	WYOMING***	1.000	1.000	0.880	0.986	1.000	0.860	0.971	1.000	0.839										
"MAC assignments as of May 6, 2019"																						
																						
2020 GPCIs reflect the first year of a two year update transition.																						
																						
"* January 1, 2017 through December 31, 2019, the Work GPCIs reflect a 1.0 floor as required by Section 201 of the MACRA of 2015.  "																						
"   The 1.0 Work GPCI floor expires on December 31, 2019, therefore the Work GPCIs for 2020 and 2021 do not reflect a 1.0 floor."																						
																						
**Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.																						
***PE GPCI reflects a 1.0 floor for frontier states established by the ACA.																						
																						
 	 																					
