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 23 * 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
J7331 - Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg 1 MG 3.115 - - - - - -
J7332 - Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg 1 MG 10.545 - - - - - -
J7336 - Capsaicin 8% patch, per square centimeter 1 SQ CM 3.423 - - - - - -
J7340 - Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml 100 ML 244.041 - - - - - -
J7345 - Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg 10 MG 1.774 - - - - - -
J7351 - Injection, bimatoprost, intracameral implant, 1 microgram 1 MCG 214.02 - - - - - -
J7354 - Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg) Per 3.2 mg single-use applicator 667.073 - - - - - -
J7355 - Injection, travoprost, intracameral implant, 1 microgram 1 MCG 196.878 - - - - - -
J7356 - Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg 0.25 MG - 5 MG 0.702 - - - - - -
J7402 - Mometasone furoate sinus implant, (sinuva), 10 micrograms 10 MCG 11.345 - - - - - -
J7500 - Azathioprine, oral, 50 mg 50 MG 0.181 - - - - - -
J7502 - Cyclosporine, oral, 100 mg 100 MG 1.428 - - - - - -
J7503 - Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg 0.25 MG 1.862 - - - - - -
J7504 - Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg 250 MG 5292.432 - - - - - -
J7507 - Tacrolimus, immediate release, oral, 1 mg 1 MG 0.23 - - - - - -
J7508 - Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg 0.1 MG 0.586 - - - - - -
J7509 - Methylprednisolone oral, per 4 mg 4 MG 0.138 - - - - - -
J7510 - Prednisolone oral, per 5 mg 5 MG 0.74 - - - - - -
J7511 - Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg 25 MG 1023.124 - - - - - -
J7512 - Prednisone, immediate release or delayed release, oral, 1 mg 1 MG 0.004 - - - - - -
J7514 - Mycophenolate mofetil (myhibbin), oral suspension, 100 mg 100 MG 2.25 - - - - - -
J7515 - Cyclosporine, oral, 25 mg 25 MG 0.626 - - - - - -
J7516 - Injection, cyclosporine, 250 mg 250 MG 74.202 - - - - - -
J7517 - Mycophenolate mofetil, oral, 250 mg 250 MG 0.139 - - - - - -
J7518 - Mycophenolic acid, oral, 180 mg 180 MG 0.318 - - - - - -
* Effective April 1, 2026 through June 30, 2026

ASP (Average Sale Price) Drug Pricing History