Inj, pemivibart, 4500 mg
Products billed under this code include Pemgarda.
Payment limit per 4500 MG, by effective quarter, 3Q24 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under Q0224
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 |
|---|---|---|---|---|
| Pemgarda | Invivyd, Inc | 81960-0031-03 | 1 | $7,615.20 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $7,615.20 | +$376.20 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted September 17, 2026 |
| 3Q26 | $7,239.00 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted September 15, 2026 |
| 2Q26 | $7,239.00 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted September 15, 2026 |
| 1Q26 | $7,239.00 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted September 15, 2026 |
| 4Q25 | $7,239.00 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted September 8, 2026 |
| 3Q25 | $7,239.00 | +$655.50 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted March 10, 2026 |
| 2Q25 | $6,583.50 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted March 10, 2026 |
| 1Q25 | $6,583.50 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted December 19, 2025 |
| 4Q24 | $6,583.50 | $0.00 | 4500 MG | Inj, pemivibart, 4500 mg | v1, posted June 11, 2025 |
| 3Q24 | $6,583.50 | – | 4500 MG | Pemivibart injection | 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.
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