ASP Drug Pricing - (3rd Quarter)
July 2025
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jan 2025 (1st 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 25 * Effective Jul 1, 2025 through Sep 30, 2025
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J9035 - Injection, bevacizumab, 10 mg 10 MG 73.049 - - - - - -
J9036 - Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg 1 MG 11.993 - - - - - -
J9039 - Injection, blinatumomab, 1 microgram 1 MCG 163.206 - - - - - -
J9040 - Injection, bleomycin sulfate, 15 units 15 UNITS 20.899 - - - - - -
J9041 - Injection, bortezomib, 0.1 mg 0.1 MG 1.589 - - - - - -
J9042 - Injection, brentuximab vedotin, 1 mg 1 MG 258.516 - - - - - -
J9043 - Injection, cabazitaxel, 1 mg 1 MG 227.1 - - - - - -
J9045 - Injection, carboplatin, 50 mg 50 MG 2.111 - - - - - -
J9047 - Injection, carfilzomib, 1 mg 1 MG 55.09 - - - - - -
J9049 - Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg 0.1 MG 1.546 - - - - - -
J9050 - Injection, carmustine, 100 mg 100 MG 173.643 - - - - - -
J9055 - Injection, cetuximab, 10 mg 10 MG 78.467 - - - - - -
J9056 - Injection, bendamustine hydrochloride (vivimusta), 1 mg 1 MG 28.058 - - - - - -
J9060 - Injection, cisplatin, powder or solution, 10 mg 10 MG 1.948 - - - - - -
J9061 - Injection, amivantamab-vmjw, 2 mg 2 MG 22.207 - - - - - -
J9063 - Injection, mirvetuximab soravtansine-gynx, 1 mg 1 MG 69.52 - - - - - -
J9065 - Injection, cladribine, per 1 mg 1 MG 9.726 - - - - - -
J9071 - Injection, cyclophosphamide (auromedics), 5 mg 5 MG 0.784 - - - - - -
J9072 - Injection, cyclophosphamide (frindovyx), 5 mg 5 MG 9.003 - - - - - -
J9073 - Injection, cyclophosphamide (dr. reddy's), 5 mg 5 MG 1.156 - - - - - -
J9074 - Injection, cyclophosphamide (sandoz), 5 mg 5 MG 4.21 - - - - - -
J9075 - Injection, cyclophosphamide, not otherwise specified, 5 mg 5 MG 0.624 - - - - - -
J9076 - Injection, cyclophosphamide (baxter), 5 mg 5 MG 5.028 - - - - - -
J9100 - Injection, cytarabine, 100 mg 100 MG 0.806 - - - - - -
J9118 - Injection, calaspargase pegol-mknl, 10 units 10 UNIT 81.906 - - - - - -
* Effective Jul 1, 2025 through Sep 30, 2025

Drugs not otherwise classified - July 2025

 

Medicare Part B payment allowance limits for drugs not otherwise classified - Effective Jul 1, 2025 through Sep 30, 2025

Drug name Dosage Payment limit Notes
Vasopressin (Long Grove) 1 UNIT 2.796

ASP (Average Sale Price) Drug Pricing History