Tocilizumab for covid-19
Products billed under this code include Actemra IV.
Payment limit per 1 MG, by effective quarter, 2Q24 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under Q0249
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 |
|---|---|---|---|---|
| Actemra IV | Genentech, Inc | 50242-0135-01 | 80 | $605.52 |
| Actemra IV | Genentech, Inc | 50242-0136-01 | 200 | $1,513.80 |
| Actemra IV | Genentech, Inc | 50242-0137-01 | 400 | $3,027.60 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted September 17, 2026 |
| 3Q26 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted September 15, 2026 |
| 2Q26 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted September 15, 2026 |
| 1Q26 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted September 15, 2026 |
| 4Q25 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted September 8, 2026 |
| 3Q25 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted March 10, 2026 |
| 2Q25 | $7.569 | $0.00 | 1 MG | Tocilizumab for covid-19 | v1, posted March 10, 2026 |
| 1Q25 | $7.569 | $0.00 | 1 MG | Tocilizumab for COVID-19 | v1, posted December 19, 2025 |
| 4Q24 | $7.569 | $0.00 | 1 MG | Tocilizumab for COVID-19 | v1, posted June 11, 2025 |
| 3Q24 | $7.569 | +$0.997 | 1 MG | Tocilizumab for COVID-19 | v1, posted June 11, 2025 |
| 2Q24 | $6.572 | – | 1 MG | Tocilizumab for COVID-19 | v1, posted March 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
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025