The Quarterly Rate Reset — July 2026 payment limits
Sent Jul 23, 2026 · 818 payment limits moved · 11 new codes · 9 retired. This is the issue exactly as subscribers received it.
The Quarterly Rate Reset
CMS released the July 2026 Part B payment-limit file. Here's what changed: 818 payment limits moved, 11 codes are new, and 9 were retired.
Source: the CMS quarterly ASP pricing file (cms.gov ASP pricing files). Payment limit = ASP + 6%. Every code below links to its billing reference.
Biggest movers
| Code | Payment limit | Change |
|---|---|---|
| J1072 Inj, testosterone, azmiro |
$0.14 → $1.30 per 1 MG |
▲ 860.0% |
| J1740 Ibandronate sodium injection |
$9.06 → $45.15 per 1 MG |
▲ 398.6% |
| Q5124 Inj. byooviz, 0.1 mg |
$70.90 → $240.97 per 0.1 MG |
▲ 239.9% |
| J9297 Inj pemetrexed (sandoz) 10mg |
$1.46 → $4.88 per 10 MG |
▲ 234.4% |
| J1645 Dalteparin sodium |
$15.86 → $48.41 per 2500 IU |
▲ 205.2% |
| J8522 Capecitabine, oral, 50 mg |
$0.03 → $0.08 per 50 MG |
▲ 166.7% |
| J0744 Ciprofloxacin iv |
$0.76 → $1.72 per 200 MG |
▲ 127.8% |
| J0133 Acyclovir injection |
$0.02 → $0.04 per 5 MG |
▲ 105.9% |
New codes
- J0681 — Inj ceftobipole medocarl 3mg ($1.10 per 3 MG)
- J7674 — Methacholine chloride, neb ($1.94 per 1 MG)
- J9053 — Inj belantamab mafodot blmf ($36.25 per 0.1 MG)
- J9062 — Inj amivantamab 5mg hyaluron ($40.74 per 5 MG)
- J9161 — Inj denileuk difti-cxdl 1mcg ($12.83 per 1 MCG)
- J9174 — Inj, docetaxel (beizray) 1mg ($46.81 per 1 MG)
- J9232 — Inj docetaxel (hospira) 1 mg ($0.51 per 1 MG)
- Q0234 — Inj, tocilizumab-bavi, 1mg ($6.33 per 1 MG)
- Q0238 — Inj, tocilizumab-aazg, hospi ($5.58 per 1 MG)
- Q5098 — Inj ustekinumab-srlf, 1 mg ($11.55 per 1 MG)
Retired codes
- J0565 — Inj, bezlotoxumab, 10 mg
- J1748 — Inj, zymfentra, 10 mg
- J2840 — Inj, sebelipase alfa, 1 mg
- J3403 — Revakinagene, per implant
- J7314 — Inj., yutiq, 0.01 mg
- J9196 — Inj gemcitabine hcl (accord)
- J9295 — Injection, necitumumab, 1 mg
- J9296 — Inj pemetrexed (accord) 10mg
- J9318 — Inj romidepsin non-lyo 0.1mg
Claims using a retired code after its end date will deny. Check your charge master.
Your reload checklist
- Load the new file into your charge master and billing system.
- Re-quote patients scheduled after the effective date — their 20% share moved with the limit.
- Check open prior auths on the new and retired codes above.
Want the new numbers as patient estimates? CareCost re-quotes a patient in about 90 seconds — free during beta.