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 30 * 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
J9301 - Injection, obinutuzumab, 10 mg 10 MG 84.463 - - - - - -
J9303 - Injection, panitumumab, 10 mg 10 MG 182.189 - - - - - -
J9304 - Injection, pemetrexed (pemfexy), 10 mg 10 MG 7.994 - - - - - -
J9305 - Injection, pemetrexed, not otherwise specified, 10 mg 10 MG 6.952 - - - - - -
J9306 - Injection, pertuzumab, 1 mg 1 MG 17.2 - - - - - -
J9307 - Injection, pralatrexate, 1 mg 1 MG 386.122 - - - - - -
J9308 - Injection, ramucirumab, 5 mg 5 MG 76.565 - - - - - -
J9309 - Injection, polatuzumab vedotin-piiq, 1 mg 1 MG 143.611 - - - - - -
J9311 - Injection, rituximab 10 mg and hyaluronidase 10 mg 36.389 - - - - - -
J9312 - Injection, rituximab, 10 mg 10 MG 73.278 - - - - - -
J9314 - Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg 10 MG 10.986 - - - - - -
J9316 - Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg 10 MG 59.895 - - - - - -
J9317 - Injection, sacituzumab govitecan-hziy, 2.5 mg 2.5 MG 37.64 - - - - - -
J9319 - Injection, romidepsin, lyophilized, 0.1 mg 0.1 MG 30.713 - - - - - -
J9321 - Injection, epcoritamab-bysp, 0.16 mg 0.16 MG 57.992 - - - - - -
J9324 - Injection, pemetrexed (pemrydi rtu), 10 mg 10 MG 67.935 - - - - - -
J9325 - Injection, talimogene laherparepvec, per 1 million plaque forming units 1 million PFU 77.339 - - - - - -
J9326 - Injection, telisotuzumab vedotin-tllv, 1 mg 1 MG 146.06 - - - - - -
J9328 - Injection, temozolomide, 1 mg 1 MG 10.408 - - - - - -
J9329 - Injection, tislelizumab-jsgr, 1mg 1 MG 58.169 - - - - - -
J9330 - Injection, temsirolimus, 1 mg 1 MG 32.681 - - - - - -
J9331 - Injection, sirolimus protein-bound particles, 1 mg 1 MG 91.03 - - - - - -
J9332 - Injection, efgartigimod alfa-fcab, 2mg 2 MG 32.553 - - - - - -
J9333 - Injection, rozanolixizumab-noli, 1 mg 1 MG 23.588 - - - - - -
J9334 - Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc 2 MG 34.258 - - - - - -
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History