CMS July 2026 Medicare Part B Payment Limit Files

Name: CMS July 2026 Medicare Part B Payment Limit Files
Creator: cms.gov
CMS July 2026 Medicare Part B Payment Limit Files discovered from cms.gov.
Update frequency: monthly
Next scan: Wed, 01 Jul 2026 20:49:22 GMT
Quality: 100/100
Latest revision: 20260630204922-37083479faae
Source

cms.gov
Quality score: 100.
Source Files For 20260630204922-37083479faae

july-2026-medicare-part-b-payment-limit-files.zip: source
section 508 version of July 2026 Medicare Part B Payment Limit File 061626.csv: source
Contract Versions

Sample Rows

HCPCS Code	Short Description	HCPCS Code Dosage	Payment Limit	Co-insurance Percentage	Vaccine AWP%	Vaccine Limit	Notes
90371	Hep b ig im	1 ML	136.952	20.0
90375	Rabies ig im/sc	150 IU	281.185	20.0
90377	Rabies ig ht&sol human im/sc	150 IU	243.198	20.0
90632	Hepa vaccine adult im	1 ML	75.735	20.0
90653	Iiv adjuvant vaccine im	0.5 ML	98.16	0.0	95	98.16	see the Seasonal Influenza Vaccines Pricing webpage for current payment limits and effective dates
Current Open Data Contract YAML

dataset_id: cms-asp-july-2026-payment-limit-files
title: CMS July 2026 Medicare Part B Payment Limit Files
description: CMS July 2026 Medicare Part B Payment Limit Files discovered from cms.gov.
source_name: cms.gov
source_url: https://www.cms.gov/files/zip/july-2026-medicare-part-b-payment-limit-files.zip
update_frequency: monthly
next_scan_at: '2026-07-01T20:49:22.129558+00:00'
tags:
- cms.gov
revisions:
- revision_id: 20260630204922-8a5981db4ab8
  detected_at: '2026-06-30T20:49:22+00:00'
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  context: July 2026 Drugs Not Payable Under Part B 060226.xls detected from july-2026-medicare-part-b-payment-limit-files.zip.
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  row_count: 8
  headers:
  - HCPCS Code
  - Long Description
  - Manufacturer
  sample_rows:
  - HCPCS Code: A9521
    Long Description: Technetium tc-99m exametazime, diagnostic, per study dose, up
      to 25 millicuries
    Manufacturer: Jubilant Draximage Inc., dba Jubilant Radiopharma
  - HCPCS Code: J0716
    Long Description: Injection, centruroides immune f(ab)2, up to 120 milligrams
    Manufacturer: Rare Disease Therapeutics, Inc.
  - HCPCS Code: J0841
    Long Description: Injection, crotalidae immune f(ab')2 (equine), 120 mg
    Manufacturer: Rare Disease Therapeutics, Inc.
  - HCPCS Code: J7330
    Long Description: Autologous cultured chondrocytes, implant
    Manufacturer: Vericel Corporation
  - HCPCS Code: J7353
    Long Description: Anacaulase-bcdb, 8.8% gel, 1 gram
    Manufacturer: Vericel Corporation
  parser_errors: []
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  source_updated_at: null
  context: July 2026 Medicare Part B Payment Limit File 061626.xls detected from july-2026-medicare-part-b-payment-limit-files.zip.
  assets:
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  row_count: 890
  headers:
  - HCPCS Code
  - Short Description
  - HCPCS Code Dosage
  - Payment Limit
  - Co-insurance Percentage
  - Vaccine AWP%
  - Vaccine Limit
  - Blood AWP%
  - Blood limit
  - Clotting Factor
  - Notes
  sample_rows:
  - HCPCS Code: 90371
    Short Description: Hep b ig im
    HCPCS Code Dosage: 1 ML
    Payment Limit: 136.952
    Co-insurance Percentage: 20
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90375
    Short Description: Rabies ig im/sc
    HCPCS Code Dosage: 150 IU
    Payment Limit: 281.185
    Co-insurance Percentage: 20
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90377
    Short Description: Rabies ig ht&sol human im/sc
    HCPCS Code Dosage: 150 IU
    Payment Limit: 243.198
    Co-insurance Percentage: 20
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90632
    Short Description: Hepa vaccine adult im
    HCPCS Code Dosage: 1 ML
    Payment Limit: 75.735
    Co-insurance Percentage: 20
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90653
    Short Description: Iiv adjuvant vaccine im
    HCPCS Code Dosage: 0.5 ML
    Payment Limit: 98.16
    Co-insurance Percentage: 0
    Vaccine AWP%: 95
    Vaccine Limit: 98.16
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: see the Seasonal Influenza Vaccines Pricing webpage for current payment
      limits and effective dates
  parser_errors: []
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  detected_at: '2026-06-30T20:49:22+00:00'
  source_updated_at: null
  context: section 508 version of July 2026 Drugs Not Payable Under Part B 060226.csv
    detected from july-2026-medicare-part-b-payment-limit-files.zip.
  assets:
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  row_count: 8
  headers:
  - HCPCS Code
  - Long Description
  - Manufacturer
  sample_rows:
  - HCPCS Code: A9521
    Long Description: Technetium tc-99m exametazime, diagnostic, per study dose, up
      to 25 millicuries
    Manufacturer: Jubilant Draximage Inc., dba Jubilant Radiopharma
  - HCPCS Code: J0716
    Long Description: Injection, centruroides immune f(ab)2, up to 120 milligrams
    Manufacturer: Rare Disease Therapeutics, Inc.
  - HCPCS Code: J0841
    Long Description: Injection, crotalidae immune f(ab')2 (equine), 120 mg
    Manufacturer: Rare Disease Therapeutics, Inc.
  - HCPCS Code: J7330
    Long Description: Autologous cultured chondrocytes, implant
    Manufacturer: Vericel Corporation
  - HCPCS Code: J7353
    Long Description: Anacaulase-bcdb, 8.8% gel, 1 gram
    Manufacturer: Vericel Corporation
  parser_errors: []
- revision_id: 20260630204922-37083479faae
  detected_at: '2026-06-30T20:49:22+00:00'
  source_updated_at: null
  context: section 508 version of July 2026 Medicare Part B Payment Limit File 061626.csv
    detected from july-2026-medicare-part-b-payment-limit-files.zip.
  assets:
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  row_count: 890
  headers:
  - HCPCS Code
  - Short Description
  - HCPCS Code Dosage
  - Payment Limit
  - Co-insurance Percentage
  - Vaccine AWP%
  - Vaccine Limit
  - Blood AWP%
  - Blood limit
  - Clotting Factor
  - Notes
  sample_rows:
  - HCPCS Code: 90371
    Short Description: Hep b ig im
    HCPCS Code Dosage: 1 ML
    Payment Limit: 136.952
    Co-insurance Percentage: 20.0
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90375
    Short Description: Rabies ig im/sc
    HCPCS Code Dosage: 150 IU
    Payment Limit: 281.185
    Co-insurance Percentage: 20.0
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90377
    Short Description: Rabies ig ht&sol human im/sc
    HCPCS Code Dosage: 150 IU
    Payment Limit: 243.198
    Co-insurance Percentage: 20.0
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90632
    Short Description: Hepa vaccine adult im
    HCPCS Code Dosage: 1 ML
    Payment Limit: 75.735
    Co-insurance Percentage: 20.0
    Vaccine AWP%: ''
    Vaccine Limit: ''
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: ''
  - HCPCS Code: 90653
    Short Description: Iiv adjuvant vaccine im
    HCPCS Code Dosage: 0.5 ML
    Payment Limit: 98.16
    Co-insurance Percentage: 0.0
    Vaccine AWP%: 95
    Vaccine Limit: 98.16
    Blood AWP%: ''
    Blood limit: ''
    Clotting Factor: ''
    Notes: see the Seasonal Influenza Vaccines Pricing webpage for current payment
      limits and effective dates
  parser_errors: []
related_dataset_ids: []
quality:
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  parsing_errors: []
  stale_warning: null
  broken_source_report: null
rss_feed_url: null
odc_version: 0.1