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CMS-1403-FC
the average wage index value for all urban areas within the
State of Georgia.
For CY 2008, we adopted an alternative methodology for
establishing a wage index value for rural Massachusetts.
Because we used the same wage index value for 2 years with
no update, we believed it was appropriate to establish a
methodology which employed reasonable proxy data for rural
areas (including rural Massachusetts), and also permitted
annual updates to the wage index based on that proxy data.
For rural areas without hospital wage data, we used the
average wage index values from all contiguous CBSAs as a
reasonable proxy for that rural area.
In determining the imputed rural wage index, we
interpreted the term “contiguous” to mean sharing a border.
In the case of Massachusetts, the entire rural area
consists of Dukes and Nantucket Counties. We determined
that the borders of Dukes and Nantucket counties are
contiguous with Barnstable and Bristol counties. We will
continue to use the same methodology for CY 2009. Under
this methodology, the CY 2009 wage index values for the
counties of Barnstable (CBSA 12700, Barnstable Town, MA—
1.2643) and Bristol (CBSA 39300, Providence-New Bedford-
Fall River, RI-MA—1.0696) were averaged resulting in an
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