Hiv prep, oral lenacapavir
Products billed under this code include Yeztugo.
Payment limit per 300 MG, by effective quarter, 4Q25 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J0752
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 |
|---|---|---|---|---|
| Yeztugo | Gilead Sciences INC. | 61958-3401-01 | 4 | $2,471.784 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $617.946 | −$2.963 | 300 MG | Hiv prep, oral lenacapavir | v1, posted September 17, 2026 |
| 3Q26 | $620.909 | −$1.05 | 300 MG | Hiv prep, oral lenacapavir | v1, posted September 15, 2026 |
| 2Q26 | $621.959 | −$1.189 | 300 MG | Hiv prep, oral lenacapavir | v1, posted September 15, 2026 |
| 1Q26 | $623.148 | +$174.118 | 300 MG | Hiv prep, oral lenacapavir | v1, posted September 15, 2026 |
| 4Q25 | $449.03 | – | 300 MG | Hiv prep, oral lenacapavir | v1, posted September 8, 2026 |
“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.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026