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 35 * 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
`Q9963` - High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml	1 ML	0.214	-	-	-	-	-	-
`Q9965` - Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml	1 ML	0.75	-	-	-	-	-	-
`Q9966` - Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml	1 ML	0.435	-	-	-	-	-	-
`Q9967` - Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	1 ML	0.155	-	-	-	-	-	-
`Q9991` - Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg	Less than or equal to 100 MG	2068.155	-	-	-	-	-	-
`Q9992` - Injection, buprenorphine extended-release (sublocade), greater than 100 mg	Greater than 100 MG	2068.155	-	-	-	-	-	-
`Q9997` - Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg	1 MG	8.552	-	-	-	-	-	-
`Q9998` - Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg	1 MG	10.529	-	-	-	-	-	-
`Q9999` - Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg	1 MG	13.154	-	-	-	-	-	-
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History