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 26 * 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
J7644 - Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram 1 MG 0.400 - - - - - -
J7674 - Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg 1 MG 1.898 - - - - - -
J7677 - Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram 1 MCG 0.200 - - - - - -
J7682 - Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams 300 MG 12.470 - - - - - -
J7686 - Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg 1.74 MG 791.981 - - - - - -
J8501 - Aprepitant, oral, 5 mg 5 MG 2.770 - - - - - -
J8522 - Capecitabine, oral, 50 mg 50 MG 0.038 - - - - - -
J8530 - Cyclophosphamide; oral, 25 mg 25 MG 1.819 - - - - - -
J8540 - Dexamethasone, oral, 0.25 mg 0.25 MG 0.009 - - - - - -
J8560 - Etoposide; oral, 50 mg 50 MG 86.790 - - - - - -
J8610 - Methotrexate; oral, 2.5 mg 2.5 MG 0.151 - - - - - -
J8611 - Methotrexate (jylamvo), oral, 2.5 mg 2.5 MG 18.641 - - - - - -
J8612 - Methotrexate (xatmep), oral, 2.5 mg 2.5 MG 22.433 - - - - - -
J8655 - Netupitant 300 mg and palonosetron 0.5 mg, oral 0.5 MG 380.188 - - - - - -
J8670 - Rolapitant, oral, 1 mg 1 MG 2.003 - - - - - -
J8700 - Temozolomide, oral, 5 mg 5 MG 0.542 - - - - - -
J8705 - Topotecan, oral, 0.25 mg 0.25 mg 125.090 - - - - - -
J9000 - Injection, doxorubicin hydrochloride, 10 mg 10 MG 2.783 - - - - - -
J9011 - Injection, datopotamab deruxtecan-dlnk, 1 mg 1 MG 51.552 - - - - - -
J9017 - Injection, arsenic trioxide, 1 mg 1 MG 7.388 - - - - - -
J9021 - Injection, asparaginase, recombinant, (rylaze), 0.1 mg 0.1 MG 56.176 - - - - - -
J9022 - Injection, atezolizumab, 10 mg 10 MG 93.910 - - - - - -
J9023 - Injection, avelumab, 10 mg 10 MG 104.986 - - - - - -
J9024 - Injection, atezolizumab, 5 mg and hyaluronidase-tqjs 5 MG 32.101 - - - - - -
J9025 - Injection, azacitidine, 1 mg 1 MG 0.463 - - - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History