Asp Payment Limit
asp_payment_limitWhat Medicare Part B PAYS for a drug administered by a provider — the quarterly ASP payment limit, set by statute at 106% of the manufacturer-reported Average Sales Price. Look up by HCPCS J-code ("J9271") or drug name ("pembrolizumab", "Keytruda"). This is the clinic/infusion benchmark: oncology drugs, biologics, injectables and vaccines. Returns the limit per its dosage unit, the quarter it is in force, AND the earlier quarter of ASP data it was derived from — those differ by two quarters and the gap matters. For retail pharmacy acquisition cost use nadac_price instead. Keyless.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| drug | No | Drug name or fragment matched against the short description, e.g. "pembrolizumab", "rituximab". Give either this or `hcpcs`. | |
| hcpcs | No | HCPCS code, e.g. "J9271" (pembrolizumab), "J0178" (aflibercept), "90632". | |
| limit | No | Max codes to return when searching by name, 1–100 (default 20). | |
| quarter | No | Optional quarter as a date in it, or "YYYY-Qn" (e.g. "2026-Q1", "2026-01-01"). Defaults to the most recent quarter loaded. |