2015 CMS Hospital Outpatient Prospective Payment System Proposed Rule Indicates Breast Biopsy Reimbursement Correction

CMS released the 2015 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule on July 3^rd, 2014.  The rule indicates reimbursement rates for breast biopsy procedures performed in the Hospital Outpatient setting will realize a 51 percent increase over 2014 rates (Proposed 2015 payment is $1,062.28 for codes 19081, 19083 and 19085, as compared to 2014 rates of $702.08).  The proposed 2015 rates will restore reimbursement to reasonable rates that are aligned with prior year’s values for vacuum-assisted breast biopsy.