ASP Drug Pricing - (2nd Quarter)
April 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Oct 2025 (4th Quarter) ASP data.
  • Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate Medicare coverage of the drug. Similarly, the inclusion of a payment allowance limit within a specific column does not indicate Medicare coverage of the drug in that specific category. These determinations shall be made by the local Medicare contractor processing the claim.
 
Page 13 * Effective April 1, 2026 through June 30, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J1837 - Injection, posaconazole, 1 mg 1 MG 0.347 - - - - - -
J1885 - Injection, ketorolac tromethamine, per 15 mg 15 MG 0.341 - - - - - -
J1920 - Injection, labetalol hydrochloride, 5 mg 5 MG 0.257 - - - - - -
J1921 - Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg 5 MG 0.903 - - - - - -
J1930 - Injection, lanreotide, 1 mg 1 MG 35.722 - - - - - -
J1931 - Injection, laronidase, 0.1 mg 0.1 MG 39.954 - - - - - -
J1932 - Injection, lanreotide, (cipla), 1 mg 1 MG 32.19 - - - - - -
J1938 - Injection, furosemide, 1 mg 1 MG 0.017 - - - - - -
J1939 - Injection, bumetanide, 0.5 mg 0.5 MG 0.473 - - - - - -
J1943 - Injection, aripiprazole lauroxil, (aristada initio), 1 mg 1 MG 3.251 - - - - - -
J1944 - Injection, aripiprazole lauroxil, (aristada), 1 mg 1 MG 3.316 - - - - - -
J1950 - Injection, leuprolide acetate (for depot suspension), per 3.75 mg 3.75 MG 1765.574 - - - - - -
J1951 - Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg 0.25 MG 140.709 - - - - - -
J1952 - Leuprolide injectable, camcevi, 1 mg 1 mg 39.947 - - - - - -
J1953 - Injection, levetiracetam, 10 mg 10 MG 0.034 - - - - - -
J1954 - Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg 7.5 MG 693.557 - - - - - -
J1955 - Injection, levocarnitine, per 1 gm 1 GM 23.087 - - - - - -
J1956 - Injection, levofloxacin, 250 mg 250 MG 2.163 - - - - - -
J1961 - Injection, lenacapavir (only for use as hiv treatment), 1 mg 1 MG 22.298 - - - - - -
J2002 - Injection, lidocaine hcl in 5% dextrose, 1 mg 1 MG 0.003 - - - - - -
J2010 - Injection, lincomycin hcl, up to 300 mg 300 MG 4.715 - - - - - -
J2020 - Injection, linezolid, 200 mg 200 MG 2.483 - - - - - -
J2021 - Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg 200 MG 26.834 - - - - - -
J2060 - Injection, lorazepam, 2 mg 2 MG 1.66 - - - - - -
J2151 - Injection, mannitol, 250 mg 250 MG 0.053 - - - - - -
* Effective April 1, 2026 through June 30, 2026

ASP (Average Sale Price) Drug Pricing History