Rxcurve
Medicare Part B payment limits Effective October 1 – December 31, 2026 Posted by CMS September 17, 2026
HCPCS J1096 · per 0.1 MG

Dexametha opth insert 0.1 mg

Products billed under this code include Dextenza.

Payment limit per 0.1 MG, by effective quarter, 1Q25 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.

Products billed under J1096

From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.

ProductLabelerNDCUnits / pkgLimit / pkg
Dextenza Ocular Therapeutix 70382-0204-01 4 $351.608
Dextenza Ocular Therapeutix 70382-0204-10 40 $3,516.08

Every quarter

QuarterPayment limitChangeBilling unitDescriptionSource file
4Q26 $87.902 −$2.117 0.1 MG Dexametha opth insert 0.1 mg v1, posted September 17, 2026
3Q26 $90.019 −$2.528 0.1 MG Dexametha opth insert 0.1 mg v1, posted September 15, 2026
2Q26 $92.547 −$6.11 0.1 MG Dexametha opth insert 0.1 mg v1, posted September 15, 2026
1Q26 $98.657 −$4.278 0.1 MG Dexametha opth insert 0.1 mg v1, posted September 15, 2026
4Q25 $102.935 +$1.449 0.1 MG Dexametha opth insert 0.1 mg v1, posted September 8, 2026
3Q25 $101.486 −$9.194 0.1 MG Dexametha opth insert 0.1 mg v1, posted March 10, 2026
2Q25 $110.68 −$2.267 0.1 MG Dexametha opth insert 0.1 mg v1, posted March 10, 2026
1Q25 $112.947 – 0.1 MG Dexametha opth insert 0.1 mg v1, posted December 19, 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.

CMS source files