In this task, you are given a summary for US Congressional and California state bill, your task is to generate a Title for this bill. The preferred titles are under forty words and mention the purpose of the bill.

Medicare Payment Improvement Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services (HHS) to determine a value index for the physician work component for each Medicare physician fee schedule area.
To amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule.