Products billed under this code include Admelog, Apidra, Humalog, Humalog Kwikpen, Humalog Tempo Pen, Humilin R, Humulin N, Humulin R, Insulin Aspart, Insulin Lispro, Insulin Lispro Junior Kwikpen, Insulin Lispro Kwikpen, Novolin N, Novolin R, Novolog, Novolog Flexpen, Novolog Penfill.
Payment limit per 50 UNITS, by effective quarter, 1Q21 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 |
|---|---|---|---|---|
| Admelog | Sanofi-Aventis U.S. LLC | 00024-5924-10 | 20 | $62.32 |
| Admelog | Sanofi-Aventis U.S. LLC | 00024-5925-05 | 30 | $93.48 |
| Admelog | Sanofi-Aventis U.S. LLC | 00024-5926-05 | 6 | $18.696 |
| Apidra | Sanofi-Aventis U.S. LLC | 00088-2500-33 | 20 | $62.32 |
| Humalog | Eli Lilly and Company | 00002-7510-01 | 20 | $62.32 |
| Humalog | Eli Lilly and Company | 00002-7510-17 | 6 | $18.696 |
| Humalog | Eli Lilly and Company | 00002-7516-59 | 30 | $93.48 |
| Humalog | Eli Lilly and Company | 00002-7533-01 | 6 | $18.696 |
| Humalog | A-S Medication Solutions | 50090-1375-00 | 20 | $62.32 |
| Humalog Kwikpen | Eli Lilly and Company | 00002-8799-59 | 30 | $93.48 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Humalog Tempo Pen | Eli Lilly and Company | 00002-8213-05 | 30 | $93.48 |
| Humilin R | Eli Lilly and Company | 00002-0213-01 | 6 | $18.696 |
| Humulin N | A-S Medication Solutions | 50090-0352-00 | 20 | $62.32 |
| Humulin R | Eli Lilly and Company | 00002-8215-01 | 20 | $62.32 |
| Humulin R | Eli Lilly and Company | 00002-8215-17 | 6 | $18.696 |
| Humulin R | Eli Lilly and Company | 00002-8501-01 | 200 | $623.20 |
| Humulin R | A-S Medication Solutions | 50090-0353-00 | 20 | $62.32 |
| Insulin Aspart | A-S Medication Solutions | 50090-4956-00 | 30 | $93.48 |
| Insulin Lispro | Eli Lilly and Company | 00002-7737-01 | 20 | $62.32 |
| Insulin Lispro | A-S Medication Solutions | 50090-5391-00 | 20 | $62.32 |
| Insulin Lispro Junior Kwikpen | Eli Lilly and Company | 00002-7752-05 | 30 | $93.48 |
| Insulin Lispro Kwikpen | Eli Lilly and Company | 00002-8222-59 | 30 | $93.48 |
| Novolin N | A-S Medication Solutions | 50090-0498-00 | 20 | $62.32 |
| Novolin R | A-S Medication Solutions | 50090-0497-00 | 20 | $62.32 |
| Novolog | Novo Nordisk, Inc | 00169-7501-11 | 20 | $62.32 |
| Novolog | A-S Medication Solutions | 50090-1664-00 | 20 | $62.32 |
| Novolog Flexpen | Novo Nordisk, Inc | 00169-6339-10 | 30 | $93.48 |
| Novolog Flexpen | A-S Medication Solutions | 50090-1678-00 | 30 | $93.48 |
| Novolog Penfill | Novo Nordisk, Inc | 00169-3303-12 | 30 | $93.48 |
| insulin aspart | Novo Nordisk, Inc | 00169-2100-11 | 20 | $62.32 |
| insulin aspart | Novo Nordisk, Inc | 00169-2101-25 | 30 | $93.48 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $3.116 | +$0.054 | 50 UNITS | Insulin for insulin pump use | v1, posted September 17, 2026 |
| 3Q26 | $3.062 | −$0.066 | 50 UNITS | Insulin for insulin pump use | v1, posted September 15, 2026 |
| 2Q26 | $3.128 | −$0.072 | 50 UNITS | Insulin for insulin pump use | v1, posted September 15, 2026 |
| 1Q26 | $3.20 | +$0.013 | 50 UNITS | Insulin for insulin pump use | v1, posted September 15, 2026 |
| 4Q25 | $3.187 | −$0.05 | 50 UNITS | Insulin for insulin pump use | v1, posted September 8, 2026 |
| 3Q25 | $3.237 | +$0.746 | 50 UNITS | Insulin for insulin pump use | v1, posted March 10, 2026 |
| 2Q25 | $2.491 | +$0.109 | 50 UNITS | Insulin for insulin pump use | v1, posted March 10, 2026 |
| 1Q25 | $2.382 | −$0.08 | 50 UNITS | Insulin for insulin pump use | v1, posted December 19, 2025 |
| 4Q24 | $2.462 | +$0.01 | 50 UNITS | Insulin for insulin pump use | v1, posted June 11, 2025 |
| 3Q24 | $2.452 | −$5.143 | 50 UNITS | Insulin for insulin pump use | v1, posted June 11, 2025 |
| 2Q24 | $7.595 | −$0.364 | 50 UNITS | Insulin for insulin pump use | v1, posted March 11, 2025 |
| 1Q24 | $7.959 | −$0.343 | 50 UNITS | Insulin for insulin pump use | v1, posted December 19, 2024 |
| 4Q23 | $8.302 | −$0.14 | 50 UNITS | Insulin for insulin pump use | v1, posted October 10, 2024 |
| 3Q23 | $8.442 | −$0.295 | 50 UNITS | Insulin for insulin pump use | v1, posted June 5, 2024 |
| 2Q23 | $8.737 | +$0.297 | 50 UNITS | Insulin for insulin pump use | v1, posted February 23, 2024 |
| 1Q23 | $8.44 | −$0.027 | 50 UNITS | Insulin for insulin pump use | v1, posted December 6, 2023 |
| 4Q22 | $8.467 | +$0.156 | 50 UNITS | Insulin for insulin pump use | v1, posted June 22, 2023 |
| 3Q22 | $8.311 | −$0.633 | 50 UNITS | Insulin for insulin pump use | v1, posted June 9, 2023 |
| 2Q22 | $8.944 | −$2.008 | 50 UNITS | Insulin for insulin pump use | v1, posted December 14, 2022 |
| 1Q22 | $10.952 | −$0.186 | 50 UNITS | Insulin for insulin pump use | v1, posted June 8, 2022 |
| 4Q21 | $11.138 | +$0.384 | 50 UNITS | Insulin for insulin pump use | v1, posted June 2, 2022 |
| 3Q21 | $10.754 | −$0.033 | 50 UNITS | Insulin for insulin pump use | v1, posted June 2, 2022 |
| 2Q21 | $10.787 | −$0.11 | 50 UNITS | Insulin for insulin pump use | v1, posted March 1, 2022 |
| 1Q21 | $10.897 | – | 50 UNITS | Insulin for insulin pump use | v1, posted December 10, 2021 |
“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.
