ASP Drug Pricing - (1st Quarter)
January 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jul 2025 (3nd Quarter) ASP data.
  • Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate whether Medicare covers a drug. These determinations shall be made by the local Medicare contractor processing the claim.
 
Page 1 * Effective January 1, 2026 through March 31, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
90371 - Hep b ig im 1 ML 137.828 - - - - - -
90375 - Rabies ig im/sc 150 IU 279.949 - - - - - -
90377 - Rabies ig ht&sol human im/sc 150 IU 240.133 - - - - - -
90586 - Bcg vaccine intravesical 1 EACH 163.971 - - - - - -
90632 - Hepa vaccine adult im 1 ML 73.542 - - - - - -
90653 - Iiv adjuvant vaccine im 0.5 ML 98.160 95% 98.160 - - - -
90656 - IIV3 VACC NO PRSV 0.5 ML IM 0.5 ML 23.215 95% 23.215 - - - -
90657 - IIV3 VACCINE SPLT 0.25 ML IM 0.25 ML 11.034 95% 11.034 - - - -
90658 - IIV3 VACCINE SPLT 0.5 ML IM 0.5 ML 22.069 95% 22.069 - - - -
90660 - LAIV3 Vaccine Intranasal 0.2 ML 29.714 95% 29.714 - - - -
90661 - CCIIV3 VACCINE NO PRSC 0.5ML IM 0.5 ML 49.495 95% 49.495 - - - -
90662 - Iiv no prsv increased ag im 0.5 ML 98.160 95% 98.160 - - - -
90671 - PCV15 vaccine IM 1 EA 269.306 95% 269.306 - - - -
90673 - Riv3 vaccine no preserv im 0.5 ML 98.160 95% 98.160 - - - -
90675 - Rabies vaccine im 1 ML 319.748 - - - - - -
90677 - Pcv20 vaccine im 0.5 ML 312.902 95% 312.902 - - - -
90684 - PCV21 VACCINE IM 0.5 ML 344.252 95% 344.252 - - - -
90714 - Td vacc no presv 7 yrs+ im 0.5 ML 38.972 - - - - - -
90715 - Tdap vaccine 7 yrs/> im 0.5 ML 39.690 - - - - - -
90732 - Ppsv23 vacc 2 yrs+ subq/im 0.5 ML 133.472 95% 133.472 - - - -
90739 - Hepb vacc 2 dose adult im 1 DOSE 177.555 95% 177.555 - - - -
90740 - Hepb vacc 3 dose immunsup im 40 MCG 164.422 95% 164.422 - - - -
90743 - Hep b vacc, adol, 2 dose, im 1 DOSE 75.145 95% 75.145 - - - -
90744 - Hepb vacc 3 dose ped/adol im 1 DOSE 33.204 95% 33.204 - - - -
90746 - Hepb vaccine 3 dose adult im 20 MCG 75.145 95% 75.145 - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History