WASHINGTON – U.S. Senators Bill Cassidy, M.D. (R-LA) and Richard Blumenthal (D-CT) introduced the Medicare Beneficiary Co-Pay Fairness Act of 2025 to make Medicare’s co-pay structure more affordable by extending the existing co-pay cap to Ambulatory Surgery Centers (ASCs), ensuring fairer costs for patients, and supporting the continued growth and utilization of efficient, lower-cost surgical settings.
“If your grandmother depended on Medicare for life-saving treatment, you would not want to hear that Medicare was cutting corners,” said Dr. Cassidy. “This bill makes costs fairer for patients while keeping the quality of care high.”
Background
Currently, while patients in both ASCs and Hospital Outpatient Departments (HOPDs) typically face a 20% co-pay, only HOPDs benefit from a co-pay cap, set at $1,676 for 2025. This leaves Medicare patients utilizing the over 6,300 Medicare-certified ASCs nationwide with potentially higher out-of-pocket expenses for approximately 150 procedures, even though ASCs offer high-quality, cost-effective care projected to save Medicare billions.
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