Urban Institute researcher, Stephen Zuckerman, testifies before the Ways and Means Committee on the geographic practice costs adjustment in the Medicare Physician Fee Schedule. He explains why it is necessary to adjust for differences in the costs of physicians' time as well as other practice expenses (employee wages, office rents and malpractice insurance premiums). The testimony argues against setting an arbitrary floor on the geographic adjuster for physicians' time as a way of raising Medicare fees in low cost areas.