Inj. acthar gel to 40 units
Products billed under this code include Acthar Gel, H.P. Acthar.
Payment limit per 40 UNITS, by effective quarter, 4Q23 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J0801
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 |
|---|---|---|---|---|
| Acthar Gel | Mallinckrodt ARD LLC | 63004-8711-04 | 8 | $31,074.136 |
| Acthar Gel | Mallinckrodt ARD LLC | 63004-8712-04 | 4 | $15,537.068 |
| H.P. Acthar | Mallinckrodt ARD LLC | 63004-8710-01 | 10 | $38,842.67 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $3,884.267 | −$249.182 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted September 17, 2026 |
| 3Q26 | $4,133.449 | +$39.19 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted September 15, 2026 |
| 2Q26 | $4,094.259 | −$78.271 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted September 15, 2026 |
| 1Q26 | $4,172.53 | +$37.908 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted September 15, 2026 |
| 4Q25 | $4,134.622 | −$52.805 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted September 8, 2026 |
| 3Q25 | $4,187.427 | +$293.998 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted March 10, 2026 |
| 2Q25 | $3,893.429 | +$65.602 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted March 10, 2026 |
| 1Q25 | $3,827.827 | +$77.747 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted December 19, 2025 |
| 4Q24 | $3,750.08 | +$270.554 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted June 11, 2025 |
| 3Q24 | $3,479.526 | +$109.139 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted June 11, 2025 |
| 2Q24 | $3,370.387 | −$301.944 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted March 11, 2025 |
| 1Q24 | $3,672.331 | −$101.833 | 40 UNITS | Inj. acthar gel to 40 units | v1, posted December 19, 2024 |
| 4Q23 | $3,774.164 | – | 40 UNITS | Corticotropin injection | v1, posted October 10, 2024 |
“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
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024