Medicare payment locality · Q3 2024 release

Bakersfield, Ca CA Medicare Locality 54

MAC 01112 · Locality 54

This locality's GPCIs are mixed, so the net payment effect varies by code for the Q3 2024 Physician Fee Schedule. For nationally priced services, Medicare adjusts each code's work, practice-expense, and malpractice RVUs using these indexes.

Work GPCI

1.017

Adjusts the physician-work component for professional labor costs

Practice expense GPCI

1.093

Adjusts practice-expense inputs such as staff, rent, and services

Malpractice GPCI

0.662

Adjusts the malpractice component using liability-cost data

1.000 is the national baseline. Above raises that component; below lowers it. GPCIs are Medicare payment factors, not general cost-of-living or physician-compensation indexes.

Example rates in Bakersfield, Ca Copy link

National vs. Bakersfield, Ca office (non-facility) amounts for frequently reviewed codes, Q3 2024 (before sequestration). Conversion factor: 2024 standard (non-QP) physician conversion factor · $33.2875.

Code	National	Bakersfield, Ca	Difference
99214	$128.16	$133.21	+3.9%
99213	$90.87	$94.60	+4.1%
99215	$180.42	$186.96	+3.6%
66984	$537.26	$560.74	+4.4%
99204	$167.10	$172.62	+3.3%
92014	$125.49	$133.00	+6.0%
97110	$29.29	$30.74	+5.0%
88305	$71.57	$76.04	+6.2%
97530	$36.62	$38.76	+5.8%
99203	$111.51	$115.54	+3.6%

Need a specific code or a facility rate? Use the rate calculator with this locality selected. Or start from your field's usual procedure mix on the specialty fee schedules.

ZIP codes in this locality Copy link

Bakersfield, Ca covers 70 ZIP codes across CA, per the CMS ZIP-to-locality crosswalk (Q3 2024). 8 of them span more than one locality and need ZIP+4 for an exact match.

93203 93205 93206 93215 93216 93220 93222 93224 93225 93226 93238 93240 93241 93243 93249 93250 93251 93252 93255 93263 93268 93276 93280 93283 93285 93287 93301 93302 93303 93304 93305 93306 93307 93308 93309 93311 93312 93313 93314 93380 93381 93382 93383 93384 93385 93386 93387 93388 93389 93390 93501 93502 93504 93505 93516 93518 93519 93523 93524 93527 93528 93531 93554 93555 93556 93558 93560 93561 93581 93596

Not sure which locality your ZIP is in? Look it up by ZIP code.

Common questions Copy link

Why do Medicare rates in Bakersfield, Ca differ from the national amount?

For nationally priced Physician Fee Schedule services, Medicare adjusts each code's work, practice-expense, and malpractice RVUs by this locality's three GPCIs before applying the conversion factor. Local professional labor, office-input, and liability costs therefore move the final amount up or down. Bakersfield, Ca currently has mixed GPCI components, so the net payment effect varies by code for the Q3 2024 release.

How do I know if my address is in this locality?

Medicare payment localities are geographic fee-schedule areas, commonly defined with county boundaries. CMS uses the service-location ZIP code to map a claim to the applicable carrier and locality. Look up your ZIP to find your locality. About 8 ZIP codes in Bakersfield, Ca span more than one locality and need the ZIP+4 to resolve exactly.

Do commercial insurers or Medicare Advantage plans use this locality?

Original Medicare uses these PFS localities directly. Commercial and Medicare Advantage plans are not required to use the same locality structure. A contract may benchmark payment to Medicare, but its language controls the Medicare release, percentage, geographic basis, and other adjustments.

Does my locality affect what I owe as a patient?

For a particular covered service, a higher locality-adjusted allowed amount generally produces a higher percentage-based coinsurance amount. The effect depends on the code, the beneficiary's deductible, supplemental coverage, and other claim circumstances.

Why did my Medicare payment change even though I didn't change what I billed?

CMS publishes updated PFS files during the year. A code's amount can change because of conversion-factor, RVU, policy, or correction updates. GPCI policy values are generally established through annual rulemaking, although later files can contain corrections. See what changed each release.

Source & method Copy link

GPCIs and rates computed from the CMS Medicare Physician Fee Schedule Q3 2024 release (effective July 2024). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2024 release . Example amounts use the standard (non-QP) physician conversion factor ($33.2875) and apply this locality's GPCIs to nationally priced non-facility RVUs, before the ~2% sequestration cut. Releases are immutable: a rate retrieved for a past quarter always reflects that PFS release.

Geographic practice cost indices (Q3 2024) · rvu24c-updated-09-09-2024.zip (GPCI2024.csv row 8)

ZIP code to carrier locality crosswalk (Q3 2024) · zip-code-to-carrier-locality.zip (ZIP5_JUL2024.txt)

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