Products billed under this code include Kymriah.
Payment limit per up to 600 million CAR-positive viable T cells, by effective quarter, 4Q23 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 |
|---|---|---|---|---|
| Kymriah | Novartis Pharmaceuticals Corporation | 00078-0846-19 | 1 | $626,315.834 |
| Kymriah | Novartis Pharmaceuticals Corporation | 00078-0958-19 | 1 | $626,315.834 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $626,315.834 | +$14,622.663 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted September 17, 2026 |
| 3Q26 | $611,693.171 | −$2,487.637 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted September 15, 2026 |
| 2Q26 | $614,180.808 | +$47,649.504 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted September 15, 2026 |
| 1Q26 | $566,531.304 | −$25,194.897 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted September 15, 2026 |
| 4Q25 | $591,726.201 | +$13,401.622 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted September 8, 2026 |
| 3Q25 | $578,324.579 | −$446.544 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted March 10, 2026 |
| 2Q25 | $578,771.123 | +$13,147.287 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted March 10, 2026 |
| 1Q25 | $565,623.836 | +$36,430.981 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted December 19, 2025 |
| 4Q24 | $529,192.855 | +$5,740.294 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted June 11, 2025 |
| 3Q24 | $523,452.561 | +$5,211.881 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted June 11, 2025 |
| 2Q24 | $518,240.68 | +$7,168.183 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted March 11, 2025 |
| 1Q24 | $511,072.497 | +$26,449.008 | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | v1, posted December 19, 2024 |
| 4Q23 | $484,623.489 | – | up to 600 million CAR-positive viable T cells | Tisagenlecleucel car-pos t | 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.
