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 16 * 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
J2428 - Injection, paliperidone palmitate extended release (erzofri), 1 mg 1 MG 15.873 - - - - - -
J2430 - Injection, pamidronate disodium, per 30 mg 30 MG 12.025 - - - - - -
J2468 - Injection, palonosetron hydrochloride (posfrea), 25 micrograms 25 MCG 55.23 - - - - - -
J2469 - Injection, palonosetron hcl, 25 mcg 25 MCG 0.574 - - - - - -
J2501 - Injection, paricalcitol, 1 mcg 1 MCG 0.899 - - - - - -
J2502 - Injection, pasireotide long acting, 1 mg 1 MG 616.708 - - - - - -
J2506 - Injection, pegfilgrastim, excludes biosimilar, 0.5 mg 0.5 MG 143.233 - - - - - -
J2507 - Injection, pegloticase, 1 mg 1 MG 3929.337 - - - - - -
J2508 - Injection, pegunigalsidase alfa-iwxj, 1 mg 1 MG 225.665 - - - - - -
J2516 - Injection, pentamidine isethionate, 1 mg 1 MG 0.16 - - - - - -
J2540 - Injection, penicillin g potassium, up to 600,000 units 600000 UNITS 0.637 - - - - - -
J2543 - Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 1.125 GM 1.218 - - - - - -
J2545 - Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg 300 MG 72.997 - - - - - -
J2550 - Injection, promethazine hcl, up to 50 mg 50 MG 3.639 - - - - - -
J2560 - Injection, phenobarbital sodium, up to 120 mg 120 MG 24.769 - - - - - -
J2562 - Injection, plerixafor, 1 mg 1 MG 28.489 - - - - - -
J2596 - Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit 1 UNIT 1.134 - - - - - -
J2597 - Injection, desmopressin acetate, per 1 mcg 1 MCG 3.562 - - - - - -
J2598 - Injection, vasopressin, 1 unit 1 UNIT 0.49 - - - - - -
J2599 - Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit 1 UNIT 0.834 - - - - - -
J2601 - Injection, vasopressin (baxter), 1 unit 1 UNIT 1.753 - - - - - -
J2675 - Injection, progesterone, per 50 mg 50 MG 0.559 - - - - - -
J2679 - Injection, fluphenazine hcl, 1.25 mg 1.25 MG 7.268 - - - - - -
J2680 - Injection, fluphenazine decanoate, up to 25 mg 25 MG 5.781 - - - - - -
J2690 - Injection, procainamide hcl, up to 1 gm 1 GM 295.361 - - - - - -
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History