2006 proposed fee schedule - American Society of Clinical Oncology

ones reconfigured). Yet we also recognize that CMS is
ultimately responsible for establishing fee schedule areas.
We have considered a number of alternative locality
configurations including--
• The CMA approach which calculates county-specific
GAFs, and compares them to their locality GAF and
designating any county with a GAF at least 5 percent higher
than its locality GAF as a new locality;
• An approach that sorts counties by descending GAFs
and compares the highest county to the second highest
county. If the difference between these two counties is 5
percent or less, they are included in the same locality.
The third highest county GAF is then compared to the highest
county GAF and so on, until the next county GAP is not
within 5 percent of the highest county GAF. At that point,
the county GAF that is more than 5 percent lower than the
highest county GAF becomes the comparison for the next
lowest county GAF, to create a second locality. This
process is repeated down throughout all of the counties;
• An approach that compares the county with the
highest GAF to the statewide average, removing counties that
are 5 percent or more than the statewide average; and
• An approach that uses Metropolitan Statistical Ares
defined by the Office of Management and Budget.
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