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 26 * 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
J9034 - Injection, bendamustine hcl (bendeka), 1 mg 1 MG 12.901 - - - - - -
J9035 - Injection, bevacizumab, 10 mg 10 MG 74.355 - - - - - -
J9036 - Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg 1 MG 13.942 - - - - - -
J9038 - Injection, axatilimab-csfr, 0.1 mg 0.1 MG 55.65 - - - - - -
J9039 - Injection, blinatumomab, 1 microgram 1 MCG 163.96 - - - - - -
J9040 - Injection, bleomycin sulfate, 15 units 15 UNITS 16.598 - - - - - -
J9041 - Injection, bortezomib, 0.1 mg 0.1 MG 2.253 - - - - - -
J9042 - Injection, brentuximab vedotin, 1 mg 1 MG 268.727 - - - - - -
J9043 - Injection, cabazitaxel, 1 mg 1 MG 231.048 - - - - - -
J9045 - Injection, carboplatin, 50 mg 50 MG 2.937 - - - - - -
J9047 - Injection, carfilzomib, 1 mg 1 MG 56.239 - - - - - -
J9049 - Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg 0.1 MG 1.259 - - - - - -
J9050 - Injection, carmustine, 100 mg 100 MG 241.803 - - - - - -
J9054 - Injection, bortezomib (boruzu), 0.1 mg 0.1 MG 25.41 - - - - - -
J9055 - Injection, cetuximab, 10 mg 10 MG 80.457 - - - - - -
J9056 - Injection, bendamustine hydrochloride (vivimusta), 1 mg 1 MG 31.736 - - - - - -
J9060 - Injection, cisplatin, powder or solution, 10 mg 10 MG 2.166 - - - - - -
J9061 - Injection, amivantamab-vmjw, 2 mg 2 MG 22.631 - - - - - -
J9063 - Injection, mirvetuximab soravtansine-gynx, 1 mg 1 MG 71.128 - - - - - -
J9065 - Injection, cladribine, per 1 mg 1 MG 8.726 - - - - - -
J9071 - Injection, cyclophosphamide (auromedics), 5 mg 5 MG 0.519 - - - - - -
J9072 - Injection, cyclophosphamide (frindovyx), 5 mg 5 MG 9.103 - - - - - -
J9073 - Injection, cyclophosphamide (dr. reddy's), 5 mg 5 MG 0.503 - - - - - -
J9074 - Injection, cyclophosphamide (sandoz), 5 mg 5 MG 3.653 - - - - - -
J9075 - Injection, cyclophosphamide, not otherwise specified, 5 mg 5 MG 0.773 - - - - - -
* Effective April 1, 2026 through June 30, 2026

ASP (Average Sale Price) Drug Pricing History