ASP Drug Pricing - (1st Quarter)
January 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jul 2025 (3nd Quarter) ASP data.
  • Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate whether Medicare covers a drug. These determinations shall be made by the local Medicare contractor processing the claim.
 
Page 15 * Effective January 1, 2026 through March 31, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J2010 - Injection, lincomycin hcl, up to 300 mg 300 MG 5.399 - - - - - -
J2020 - Injection, linezolid, 200 mg 200 MG 2.742 - - - - - -
J2021 - Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg 200 MG 21.631 - - - - - -
J2060 - Injection, lorazepam, 2 mg 2 MG 1.406 - - - - - -
J2151 - Injection, mannitol, 250 mg 250 MG 0.060 - - - - - -
J2175 - Injection, meperidine hydrochloride, per 100 mg 100 MG 8.148 - - - - - -
J2182 - Injection, mepolizumab, 1 mg 1 MG 31.885 - - - - - -
J2183 - Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg 100 MG 1.572 - - - - - -
J2184 - Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg 100 MG 2.009 - - - - - -
J2185 - Injection, meropenem, 100 mg 100 MG 0.383 - - - - - -
J2210 - Injection, methylergonovine maleate, up to 0.2 mg 0.2 MG 21.363 - - - - - -
J2246 - Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg 1 MG 0.413 - - - - - -
J2247 - Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg 1 MG 0.219 - - - - - -
J2248 - Injection, micafungin sodium, 1 mg 1 MG 0.249 - - - - - -
J2250 - Injection, midazolam hydrochloride, per 1 mg 1 MG 0.141 - - - - - -
J2251 - Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg 1 MG 0.176 - - - - - -
J2260 - Injection, milrinone lactate, 5 mg 5 MG 1.351 - - - - - -
J2267 - Injection, mirikizumab-mrkz, 1 mg 1 MG 41.916 - - - - - -
J2270 - Injection, morphine sulfate, up to 10 mg 10 MG 3.036 - - - - - -
J2272 - Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 10 MG 6.771 - - - - - -
J2274 - Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg 10 MG 13.495 - - - - - -
J2277 - Injection, motixafortide, 0.25 mg 0.25 MG 26.479 - - - - - -
J2278 - Injection, ziconotide, 1 microgram 1 MCG 10.565 - - - - - -
J2280 - Injection, moxifloxacin, 100 mg 100 MG 9.156 - - - - - -
J2281 - Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg 100 MG 6.641 - - - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History