ASP Drug Pricing - (3rd Quarter)
July 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jan 2026 (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 10 * Effective Jul 1, 2026 through Sep 30, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J1439 - Injection, ferric carboxymaltose, 1 mg 1 MG 1.132 - - - - - -
J1440 - Fecal microbiota, live - jslm, 1 ml 1 ML 65.604 - - - - - -
J1442 - Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram 1 MCG 1.006 - - - - - -
J1447 - Injection, tbo-filgrastim, 1 microgram 1 MCG 0.236 - - - - - -
J1448 - Injection, trilaciclib, 1mg 1 MG 5.463 - - - - - -
J1449 - Injection, eflapegrastim-xnst, 0.1 mg 0.1 MG 38.562 - - - - - -
J1450 - Injection fluconazole, 200 mg 200 MG 6.105 - - - - - -
J1453 - Injection, fosaprepitant, 1 mg 1 MG 0.123 - - - - - -
J1454 - Injection, fosnetupitant 235 mg and palonosetron 0.25 mg 0.25 MG 503.848 - - - - - -
J1455 - Injection, foscarnet sodium, per 1000 mg 1000 MG 8.355 - - - - - -
J1456 - Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg 1 MG 0.036 - - - - - -
J1458 - Injection, galsulfase, 1 mg 1 MG 525.967 - - - - - -
J1459 - Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg 500 MG 51.218 - - - - - -
J1460 - Injection, gamma globulin, intramuscular, 1 cc 1 CC 48.874 - - - - - -
J1551 - Injection, immune globulin (cutaquig), 100 mg 100 MG 14.03 - - - - - -
J1552 - Injection, immune globulin (alyglo), 500 mg 500 MG 121.544 - - - - - -
J1553 - Injection, immune globulin (yimmugo), 100 mg 100 MG 24.145 - - - - - -
J1554 - Injection, immune globulin (asceniv), 500 mg 500 MG 509.139 - - - - - -
J1555 - Injection, immune globulin (cuvitru), 100 mg 100 MG 18.147 - - - - - -
J1556 - Injection, immune globulin (bivigam), 500 mg 500 MG 81.241 - - - - - -
J1557 - Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg 500 MG 66.272 - - - - - -
J1558 - Injection, immune globulin (xembify), 100 mg 100 MG 15.243 - - - - - -
J1559 - Injection, immune globulin (hizentra), 100 mg 100 MG 14.883 - - - - - -
J1560 - Injection, gamma globulin, intramuscular, over 10 cc 10 CC 162.519 - - - - - -
J1561 - Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg 500 MG 49.014 - - - - - -
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History