ASCA Advocates for Fix to ASC Copay Penalty

Change would reduce Medicare costs and allow more equitable access to care

BY KARA NEWBURY | MAY 2023

Medicare beneficiaries who receive treatment in either an ASC or a hospital outpatient department (HOPD) are typically responsible for 20 percent of their cost of care. In HOPDs, this 20 percent copay is capped at the hospital inpatient deductible amount ($1,600 for 2023). In ASCs, however, there is no copay cap. As a result, Medicare patients treated in an ASC face higher copays for approximately 150 procedures.

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ADVOCACY SPOTLIGHT: ASCA Advocates for Fix to ASC Copay Penalty

ADVOCACY SPOTLIGHT

ASCA Advocates for Fix to ASC Copay Penalty

Change would reduce Medicare costs and allow more equitable access to care