Anders Gilberg MGMA concerned by Medicare geographic pay adjustments for rural doctors expiring

The federal policy that helps equalize Medicare physician payments in rural and urban areas is scheduled to expire at the end of 2025, sparking concern among medical groups that rural communities could face worsening physician shortages if the adjustment is not renewed.

The policy, known as the Geographic Practice Cost Index (GPCI) adjustment, modifies how Medicare calculates payments to physicians to account for regional differences in the cost of running a medical practice. In rural areas, where physician work relative value units (RVUs) often fall below the national average, Congress has repeatedly applied what is known in Washington as the “GPCI floor” to ensure doctors receive payments more comparable to those of their urban counterparts.

Anders Gilberg, MGA, senior vice president of government affairs at the Medical Group Management Association (MGMA), said allowing the adjustment to lapse would immediately disadvantage physicians in rural communities.

“If Congress lets the GPCI adjustment expire, physicians in rural areas will see their Medicare payments reduced midyear,” he explained. “That would put them at a disadvantage compared with their urban colleagues. At a time when recruiting and retaining doctors is already difficult, this could be the straw that breaks the camel’s back.”