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 28 * 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
J9185 - Injection, fludarabine phosphate, 50 mg 50 MG 206.299 - - - - - -
J9190 - Injection, fluorouracil, 500 mg 500 MG 2.024 - - - - - -
J9200 - Injection, floxuridine, 500 mg 500 MG 4396.492 - - - - - -
J9201 - Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg 200 MG 2.884 - - - - - -
J9203 - Injection, gemtuzumab ozogamicin, 0.1 mg 0.1 MG 247.37 - - - - - -
J9204 - Injection, mogamulizumab-kpkc, 1 mg 1 MG 258.536 - - - - - -
J9205 - Injection, irinotecan liposome, 1 mg 1 MG 65.861 - - - - - -
J9206 - Injection, irinotecan, 20 mg 20 MG 1.851 - - - - - -
J9207 - Injection, ixabepilone, 1 mg 1 MG 139.754 - - - - - -
J9208 - Injection, ifosfamide, 1 gram 1 GM 27.613 - - - - - -
J9209 - Injection, mesna, 200 mg 200 MG 1.305 - - - - - -
J9210 - Injection, emapalumab-lzsg, 1 mg 1 MG 392.78 - - - - - -
J9211 - Injection, idarubicin hydrochloride, 5 mg 5 MG 38.132 - - - - - -
J9217 - Leuprolide acetate (for depot suspension), 7.5 mg 7.5 MG 160.342 - - - - - -
J9223 - Injection, lurbinectedin, 0.1 mg 0.1 MG 215.95 - - - - - -
J9226 - Histrelin implant (supprelin la), 50 mg 50 MG 37491.974 - - - - - -
J9227 - Injection, isatuximab-irfc, 10 mg 10 MG 88.16 - - - - - -
J9228 - Injection, ipilimumab, 1 mg 1 MG 190.432 - - - - - -
J9229 - Injection, inotuzumab ozogamicin, 0.1 mg 0.1 MG 2873.103 - - - - - -
J9232 - Injection, docetaxel (hospira), not therapeutically equivalent to j9171, 1 mg 1 MG 0.512 - - - - - -
J9245 - Injection, melphalan hydrochloride, not otherwise specified, 50 mg 50 MG 104.898 - - - - - -
J9246 - Injection, melphalan (evomela), 1 mg 1 MG 18.044 - - - - - -
J9248 - Injection, melphalan (hepzato), 1 mg 1 MG 801.479 - - - - - -
J9256 - Injection, nipocalimab-aahu, 3 mg 3 MG 32.568 - - - - - -
J9260 - Injection, methotrexate sodium, 50 mg 50 MG 2.941 - - - - - -
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History