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 14 * 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
J2175 - Injection, meperidine hydrochloride, per 100 mg 100 MG 8.817 - - - - - -
J2182 - Injection, mepolizumab, 1 mg 1 MG 31.823 - - - - - -
J2183 - Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg 100 MG 1.476 - - - - - -
J2184 - Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg 100 MG 1.974 - - - - - -
J2185 - Injection, meropenem, 100 mg 100 MG 0.371 - - - - - -
J2210 - Injection, methylergonovine maleate, up to 0.2 mg 0.2 MG 21.612 - - - - - -
J2246 - Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg 1 MG 0.365 - - - - - -
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 0.255 - - - - - -
J2250 - Injection, midazolam hydrochloride, per 1 mg 1 MG 0.165 - - - - - -
J2251 - Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg 1 MG 0.159 - - - - - -
J2260 - Injection, milrinone lactate, 5 mg 5 MG 1.183 - - - - - -
J2267 - Injection, mirikizumab-mrkz, 1 mg 1 MG 42.092 - - - - - -
J2270 - Injection, morphine sulfate, up to 10 mg 10 MG 4.449 - - - - - -
J2272 - Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 10 MG 8.341 - - - - - -
J2274 - Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg 10 MG 12.149 - - - - - -
J2277 - Injection, motixafortide, 0.25 mg 0.25 MG 26.479 - - - - - -
J2278 - Injection, ziconotide, 1 microgram 1 MCG 10.464 - - - - - -
J2280 - Injection, moxifloxacin, 100 mg 100 MG 8.744 - - - - - -
J2281 - Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg 100 MG 6.641 - - - - - -
J2290 - Injection, nafcillin sodium, 20 mg 20 MG 0.048 - - - - - -
J2291 - Injection, nafcillin sodium (baxter), 20 mg 20 MG 0.15 - - - - - -
J2300 - Injection, nalbuphine hydrochloride, per 10 mg 10 MG 3.421 - - - - - -
J2305 - Injection, nitroglycerin, 5 mg 5 MG 1.665 - - - - - -
J2312 - Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg 0.01 MG 0.065 - - - - - -
* Effective April 1, 2026 through June 30, 2026

ASP (Average Sale Price) Drug Pricing History