Products billed under this code include Emtricitabine/Tenofovir disoproxil fumarate, Truvada.
Payment limit per 200 mg/300 mg, by effective quarter, 4Q24 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Emtricitabine/Tenofovir disoproxil fumarate | Teva Pharmaceuticals | 00093-7704-56 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Mylan Pharmaceuticals Inc. | 00378-1930-93 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Major Pharmaceuticals | 00904-7172-07 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Northstar RxLLC | 16714-0534-01 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Camber Pharmaceuticals Inc. | 31722-0560-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | MacLeods Pharmaceuticals Limited | 33342-0106-07 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Avkare | 42291-0439-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Laurus Labs Limited | 42385-0953-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Laurus Labs Limited | 42385-0953-90 | 90 | $40.59 |
| Emtricitabine/Tenofovir disoproxil fumarate | Strides Pharma Inc | 42543-0719-04 | 30 | $13.53 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Emtricitabine/Tenofovir disoproxil fumarate | A-S Medication Solutions | 50090-6494-01 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | A-S Medication Solutions | 50090-7719-01 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Golden State Medical Supply Inc | 51407-0112-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | American Health Packaging | 60687-0719-25 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Strides Pharma Science Limited | 64380-0719-04 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Aurobindo Pharma Limited | 65862-0354-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Lupin Pharmaceuticals Inc | 68180-0287-01 | 100 | $45.10 |
| Emtricitabine/Tenofovir disoproxil fumarate | Lupin Pharmaceuticals Inc | 68180-0287-06 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Cipla USA | 69097-0741-02 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Amneal Pharmaceuticals LLC | 69238-2095-03 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Zydus Pharmaceuticals USA | 70710-1367-03 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Zydus Pharmaceuticals USA | 70710-1367-04 | 100 | $45.10 |
| Emtricitabine/Tenofovir disoproxil fumarate | Zydus Pharmaceuticals USA | 70710-1367-09 | 90 | $40.59 |
| Emtricitabine/Tenofovir disoproxil fumarate | Proficient Rx LP | 71205-0776-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Proficient Rx LP | 71205-0776-60 | 60 | $27.06 |
| Emtricitabine/Tenofovir disoproxil fumarate | Proficient Rx LP | 71205-0776-90 | 90 | $40.59 |
| Emtricitabine/Tenofovir disoproxil fumarate | Exelan Pharmaceuticals Inc | 76282-0677-30 | 30 | $13.53 |
| Emtricitabine/Tenofovir disoproxil fumarate | Quallent Pharmaceuticals LLC | 82009-0109-30 | 30 | $13.53 |
| Truvada | Physicians Total Care Inc | 54868-5141-00 | 30 | $13.53 |
| Truvada | Gilead Sciences INC. | 61958-0701-01 | 30 | $13.53 |
| Truvada | Gilead Sciences INC. | 61958-0703-01 | 15 | $6.765 |
| Truvada | Gilead Sciences INC. | 61958-0704-01 | 20 | $9.02 |
| Truvada | Gilead Sciences INC. | 61958-0705-01 | 25 | $11.275 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $0.451 | −$0.002 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted September 17, 2026 |
| 3Q26 | $0.453 | −$0.035 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted September 15, 2026 |
| 2Q26 | $0.488 | −$0.854 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted September 15, 2026 |
| 1Q26 | $1.342 | −$0.392 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted September 15, 2026 |
| 4Q25 | $1.734 | −$0.002 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted September 8, 2026 |
| 3Q25 | $1.736 | +$0.459 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted March 10, 2026 |
| 2Q25 | $1.277 | −$0.54 | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted March 10, 2026 |
| 1Q25 | $1.817 | – | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted December 19, 2025 |
| 4Q24 | N/A | – | 200 mg/300 mg | Hiv prep, ftc/tdf 200/300mg | v1, posted June 11, 2025 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
