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 13 * 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
J1837 - Injection, posaconazole, 1 mg 1 MG 0.342 - - - - - -
J1885 - Injection, ketorolac tromethamine, per 15 mg 15 MG 0.286 - - - - - -
J1920 - Injection, labetalol hydrochloride, 5 mg 5 MG 0.218 - - - - - -
J1921 - Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg 5 MG 0.906 - - - - - -
J1930 - Injection, lanreotide, 1 mg 1 MG 37.428 - - - - - -
J1931 - Injection, laronidase, 0.1 mg 0.1 MG 41.487 - - - - - -
J1932 - Injection, lanreotide, (cipla), 1 mg 1 MG 20.33 - - - - - -
J1938 - Injection, furosemide, 1 mg 1 MG 0.018 - - - - - -
J1939 - Injection, bumetanide, 0.5 mg 0.5 MG 0.498 - - - - - -
J1943 - Injection, aripiprazole lauroxil, (aristada initio), 1 mg 1 MG 3.461 - - - - - -
J1944 - Injection, aripiprazole lauroxil, (aristada), 1 mg 1 MG 3.557 - - - - - -
J1950 - Injection, leuprolide acetate (for depot suspension), per 3.75 mg 3.75 MG 1841.261 - - - - - -
J1951 - Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg 0.25 MG 145.311 - - - - - -
J1952 - Leuprolide injectable, camcevi, 1 mg 1 mg 42.059 - - - - - -
J1953 - Injection, levetiracetam, 10 mg 10 MG 0.032 - - - - - -
J1954 - Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg 7.5 MG 687.287 - - - - - -
J1955 - Injection, levocarnitine, per 1 gm 1 GM 22.607 - - - - - -
J1956 - Injection, levofloxacin, 250 mg 250 MG 1.909 - - - - - -
J1961 - Injection, lenacapavir (only for use as hiv treatment), 1 mg 1 MG 22.936 - - - - - -
J2002 - Injection, lidocaine hcl in 5% dextrose, 1 mg 1 MG 0.003 - - - - - -
J2010 - Injection, lincomycin hcl, up to 300 mg 300 MG 4.234 - - - - - -
J2020 - Injection, linezolid, 200 mg 200 MG 2.268 - - - - - -
J2021 - Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg 200 MG 34.175 - - - - - -
J2060 - Injection, lorazepam, 2 mg 2 MG 2.302 - - - - - -
J2151 - Injection, mannitol, 250 mg 250 MG 0.071 - - - - - -
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History