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 32 * 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
J9332 - Injection, efgartigimod alfa-fcab, 2mg 2 MG 32.223 - - - - - -
J9333 - Injection, rozanolixizumab-noli, 1 mg 1 MG 23.376 - - - - - -
J9334 - Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc 2 MG 34.117 - - - - - -
J9341 - Injection, thiotepa (tepylute), 1 mg 1 MG 38.550 - - - - - -
J9342 - Injection, thiotepa, not otherwise specified, 1 mg 1 MG 8.863 - - - - - -
J9345 - Injection, retifanlimab-dlwr, 1 mg 1 MG 30.527 - - - - - -
J9347 - Injection, tremelimumab-actl, 1 mg 1 MG 143.018 - - - - - -
J9348 - Injection, naxitamab-gqgk, 1 mg 1 MG 686.083 - - - - - -
J9349 - Injection, tafasitamab-cxix, 2 mg 2 MG 14.242 - - - - - -
J9350 - Injection, mosunetuzumab-axgb, 1 mg 1 MG 655.379 - - - - - -
J9351 - Injection, topotecan, 0.1 mg 0.1 MG 1.248 - - - - - -
J9352 - Injection, trabectedin, 0.1 mg 0.1 MG 391.070 - - - - - -
J9353 - Injection, margetuximab-cmkb, 5 mg 5 MG 53.749 - - - - - -
J9354 - Injection, ado-trastuzumab emtansine, 1 mg 1 MG 42.193 - - - - - -
J9355 - Injection, trastuzumab, excludes biosimilar, 10 mg 10 MG 73.483 - - - - - -
J9356 - Injection, trastuzumab, 10 mg and hyaluronidase-oysk 10 MG 61.068 - - - - - -
J9357 - Injection, valrubicin, intravesical, 200 mg 200 MG 1303.342 - - - - - -
J9358 - Injection, fam-trastuzumab deruxtecan-nxki, 1 mg 1 MG 31.300 - - - - - -
J9359 - Injection, loncastuximab tesirine-lpyl, 0.075 mg 0.075 MG 221.222 - - - - - -
J9360 - Injection, vinblastine sulfate, 1 mg 1 MG 5.183 - - - - - -
J9370 - Vincristine sulfate, 1 mg 1 MG 8.151 - - - - - -
J9380 - Injection, teclistamab-cqyv, 0.5 mg 0.5 MG 34.575 - - - - - -
J9381 - Injection, teplizumab-mzwv, 5 mcg 5 MCG 38.386 - - - - - -
J9382 - Injection, zenocutuzumab-zbco, 1 mg 1 MG 33.567 - - - - - -
J9390 - Injection, vinorelbine tartrate, 10 mg 10 MG 5.440 - - - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History