New Bill Proposes Medicare Copay Cap for Ambulatory Surgical Centers

Senators Bill Cassidy and Richard Blumenthal have introduced bipartisan legislation aimed at capping Medicare coinsurance costs for services at ambulatory surgical centers (ASCs).

Currently, Medicare patients face a 20% coinsurance for services at both ASCs and hospital outpatient departments (HOPDs), but only HOPDs have a copay cap, set at $1,676 for 2025. The proposed Medicare Beneficiary Co-Pay Fairness Act of 2025 seeks to extend this copay cap to ASCs, potentially reducing out-of-pocket expenses for Medicare beneficiaries and encouraging the use of cost-effective surgical settings.