--- title: What Else is in the Medicare Proposed Rule for 2025? description: Dive deeper into the 2025 MPFS Proposed Rule and understand the impact of GPCI Medicare adjustments on your practice. Learn how these changes will affect your reimbursement. image: https://info.hapusa.com/hubfs/What%20Else%20Is%20in%20the%20Medicare%20Proposed%20Rule%20for%202025.jpg --- ![What Else is in the Medicare Proposed Rule for 2025?](https://info.hapusa.com/hubfs/What%20Else%20Is%20in%20the%20Medicare%20Proposed%20Rule%20for%202025.jpg) # What Else is in the Medicare Proposed Rule for 2025? - [Home](https://info.hapusa.com/) - [HAP Radiology Billing and Coding Blog](https://info.hapusa.com/blog-0) - What Else is in the Medicare Proposed Rule for 2025? [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 10/28/2024 ## What Else is in the Medicare Proposed Rule for 2025? ![What Else is in the Medicare Proposed Rule for 2025?](https://info.hapusa.com/hubfs/What%20Else%20Is%20in%20the%20Medicare%20Proposed%20Rule%20for%202025.jpg "What Else is in the Medicare Proposed Rule for 2025?") ![What Else Is in the Medicare Proposed Rule for 2025](https://info.hapusa.com/hs-fs/hubfs/What%20Else%20Is%20in%20the%20Medicare%20Proposed%20Rule%20for%202025.jpg?width=300&height=168&name=What%20Else%20Is%20in%20the%20Medicare%20Proposed%20Rule%20for%202025.jpg)We previously covered the key aspects of the [2025 Medicare Physician Fee Schedule (MPFS) Proposed Rule](https://info.hapusa.com/blog-0/medicare-proposed-rule-again-cuts-radiology-reimbursement-in-2025) when it came out in July. Now, while awaiting the Final Rule, let's examine another important provision: the Geographic Practice Cost Index (GPCI Medicare) and its impact on locality-specific payments.   The GPCI is comprised of values related to Practice Expenses, Malpractice Insurance, and the cost of labor (the Work value), which act to increase or decrease the standard (national) Medicare payment in order to adjust for differences in the cost of living across the country. Medicare computes a composite of these factors called the [Geographic Adjustment Factor (GAF)](https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/Geographic_Adjustment_of_Medicare_Physician_Payments_July2012.pdf) that allows us to analyze the impact of the GPCI adjustments for each payment locality. The GAF ranges from 0.893 in Arkansas to 1.271 in Alaska, which means practices in Arkansas are paid 10.7% less than the national rate and practices in Alaska are paid 27.1% more than the national rate. [![Get Our Top 10 Radiology RCM Tips](https://no-cache.hubspot.com/cta/default/16707/301a07a9-015b-4e16-b124-8dca2c26db82.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/301a07a9-015b-4e16-b124-8dca2c26db82) Of the 109 payment localities in the Medicare system, 51 will receive a negative adjustment while 58 will see no adjustment – no locality will have a payment increase due to geographic cost factors. The table below shows those localities where the GAF will be more than 1.0% lower in 2025 than it was in 2024. Localities not listed here will see a decrease of less than 1.0%, or no change to their GAF for 2025.     | Locality Name | Locality Number | 2024 GAF | 2025 GAF | Percent Change | | --- | --- | --- | --- | --- | | MISSISSIPPI | 00 | 0.923 | 0.898 | -2.7% | | ARKANSAS | 13 | 0.916 | 0.893 | -2.5% | | REST OF MISSOURI | 99 | 0.935 | 0.913 | -2.4% | | IDAHO | 00 | 0.936 | 0.914 | -2.4% | | WEST VIRGINIA | 16 | 0.951 | 0.931 | -2.1% | | KENTUCKY | 00 | 0.940 | 0.921 | -2.0% | | MAINE | 99 | 0.946 | 0.927 | -2.0% | | UTAH | 09 | 0.967 | 0.948 | -2.0% | | KANSAS | 00 | 0.938 | 0.920 | -1.9% | | TENNESSEE | 35 | 0.933 | 0.916 | -1.8% | | IOWA | 00 | 0.938 | 0.921 | -1.8% | | OKLAHOMA | 00 | 0.942 | 0.925 | -1.8% | | LOUISIANA | 99 | 0.945 | 0.928 | -1.8% | | MONTANA | 01 | 0.999 | 0.981 | -1.8% | | GEORGIA | 99 | 0.952 | 0.936 | -1.7% | | NEBRASKA | 00 | 0.933 | 0.919 | -1.5% | | INDIANA | 00 | 0.943 | 0.929 | -1.5% | | SOUTH CAROLINA | 01 | 0.953 | 0.939 | -1.5% | | FLORIDA | 99 | 0.992 | 0.977 | -1.5% | | ILLINOIS | 99 | 0.976 | 0.962 | -1.4% | | VERMONT | 50 | 0.977 | 0.963 | -1.4% | | MICHIGAN | 99 | 0.967 | 0.954 | -1.3% | | SOUTH DAKOTA | 02 | 0.974 | 0.961 | -1.3% | | WYOMING | 21 | 0.989 | 0.976 | -1.3% | | ALABAMA | 00 | 0.923 | 0.912 | -1.2% | | NEW MEXICO | 05 | 0.965 | 0.953 | -1.2% | | NEW ORLEANS | 01 | 0.977 | 0.966 | -1.1% | | OREGON | 99 | 0.979 | 0.968 | -1.1% | | NORTH DAKOTA | 01 | 0.980 | 0.969 | -1.1% | | FORT LAUDERDALE | 03 | 1.031 | 1.020 | -1.1% | | ARIZONA | 00 | 0.983 | 0.973 | -1.0% | | MAINE | 03 | 0.991 | 0.981 | -1.0% | | EAST ST. LOUIS | 12 | 0.996 | 0.986 | -1.0% |   The worst case is for practices in Mississippi where a 2.7% GAF reduction will impact them *in addition to the 2.8% cut that all practices nationwide will experience*, for a total of a 5.5% cut in the Medicare payment rate for 2025.   It is possible that Congressional action will mitigate some of the of this cut, as it did last year. It took two short-term appropriations bills to stave off similar geographic cuts that kept the GPCI Work Floor at 1.0, the same as it was in 2023. Finally, in March the [Consolidated Appropriations Act, 2024](https://info.hapusa.com/blog-0/how-are-radiology-practices-impacted-by-annual-changes-to-the-medicare-physician-fee-schedule) revised the overall cut from 3.37% to 1.77% and further sustained the GPCI Work Floor at 1.0 for the rest of the year. In Mississippi, the 2024 payment rate would have been 8.5% lower than it was in 2023 with no Congressional action, but it became a 4.8% cut rather than 8.5%. There is no guarantee that similar action will take place for 2025. [![Contact Us](https://no-cache.hubspot.com/cta/default/16707/1088478d-a9f7-4565-8dac-15dab49f67ca.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/1088478d-a9f7-4565-8dac-15dab49f67ca) We will continue to monitor changes in the Medicare payment rate, which also influences commercial payers over the long term, and we will provide a complete review of the Medicare Physician Fee Schedule for 2025 when the final rule is released. [Subscribe to this blog](https://info.hapusa.com/subscribe-to-hap-medical-billing-and-coding-blog) for the latest information.    *[Sandy Coffta](https://info.hapusa.com/download-a-copy-of-sandy-coffta-professional-summary) is the Vice President of Client Services at [Healthcare Administrative Partners](https://www.hapusa.com/).*   **Related Articles **   [Medicare Proposed Rule Again Cuts Radiology Reimbursement in 2025](https://info.hapusa.com/blog-0/medicare-proposed-rule-again-cuts-radiology-reimbursement-in-2025)   [Radiology Updates, Reminders, And Tips For MIPS](https://info.hapusa.com/blog-0/radiology-updates-reminders-and-tips-for-mips)   [Coding For Enhanced Interventional Radiology Reimbursement](https://info.hapusa.com/blog-0/coding-for-enhanced-interventional-radiology-reimbursement)   [![Inside advice from radiology RCM experts](https://no-cache.hubspot.com/cta/default/16707/f1acf195-e6b4-46f0-bdb2-e0bf10079237.png)](https://cta-redirect.hubspot.com/cta/redirect/16707/f1acf195-e6b4-46f0-bdb2-e0bf10079237)   [Follow HAP on LinkedIn](https://www.linkedin.com/company/healthcare-administrative-partners) [Follow HAP on Twitter](https://twitter.com/hapusarcm) [Like HAP on Facebook](https://www.facebook.com/hapusarcm/)   Copyright © 2024 Healthcare Administrative Partners. 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[Read More](https://info.hapusa.com/blog-0/medicare-physician-fee-schedule-final-rule-for-2026) [ radiology reimbursement](https://info.hapusa.com/blog-0/topic/radiology-reimbursement), [ MPFS](https://info.hapusa.com/blog-0/topic/mpfs), [ radiology](https://info.hapusa.com/blog-0/topic/radiology), [ Medicare Physician Fee Schedule](https://info.hapusa.com/blog-0/topic/medicare-physician-fee-schedule) [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 04 March, 2025 #### [What is the Impact of the 2025 Medicare Fee Schedule Changes on Radiology Practices?](https://info.hapusa.com/blog-0/what-is-the-impact-of-the-2025-medicare-fee-schedule-changes-on-radiology-practices) The 2025 conversion factor (CF) that sets the overall rate for the Medicare Physician Fee Schedule... [Read More](https://info.hapusa.com/blog-0/what-is-the-impact-of-the-2025-medicare-fee-schedule-changes-on-radiology-practices) [ medicare](https://info.hapusa.com/blog-0/topic/medicare), [ medicare reimbursement](https://info.hapusa.com/blog-0/topic/medicare-reimbursement), [ MPFS](https://info.hapusa.com/blog-0/topic/mpfs), [ Quality Payment Program](https://info.hapusa.com/blog-0/topic/quality-payment-program), [ Medicare Physician Fee Schedule](https://info.hapusa.com/blog-0/topic/medicare-physician-fee-schedule) [ Sandy Coffta ](https://info.hapusa.com/blog-0/author/sandy-coffta) 15 November, 2024 #### [Medicare Cuts 2025: Finalized Fee Schedule & Impact on Radiology](https://info.hapusa.com/blog-0/medicare-finalizes-2025-fee-schedule-cut) Absent any last-minute Congressional action, physicians will suffer a 2.83% fee schedule reduction... [Read More](https://info.hapusa.com/blog-0/medicare-finalizes-2025-fee-schedule-cut)