API referenceDrugs
Look up a Medicare Part B drug payment limit
GET /v1/drugs/asp/{hcpcs}
GET https://api.healthcare.dev/v1/drugs/asp/{hcpcs}CMS Medicare Part B drug payment allowance limit (from the quarterly ASP pricing files, generally 106% of average sales price) for one billing code: the newest quarter's limit per dosage_descriptor unit, history of every quarter loaded (about two years, newest first), in_effect (the quarter that applies on date, default today), and ndcs, the products CMS's NDC-HCPCS crosswalk assigns to the code with billing units per package. CPT codes (vaccines) carry no descriptor (© AMA). A payment limit is not a coverage decision or what a patient pays.
Requires an API key: Authorization: Bearer hdev_live_.... See Authentication.
Path parameters
| Name | Type | Required | Description | Example |
|---|---|---|---|---|
hcpcs | string | yes | HCPCS Level II code, or a CPT code number | J9271 |
Query parameters
| Name | Type | Required | Description | Example |
|---|---|---|---|---|
date | string (date) | no | Answer in_effect for this date (YYYY-MM-DD; default today) | 2026-08-15 |
view | "compact" | "standard" | "full" | no | How much of each record to return (default full). compact: hcpcs, short_description, quarter, payment_limit, dosage_descriptor, in_effect, status, on_date, in_effect, ndc_count, matched_ndcs, match_score (search results) (fewest tokens, for agents). standard: every field except history, ndcs. full: every field. | compact |
fields | string | no | Comma-separated fields to return instead of a view. Valid fields: hcpcs, code_system, short_description, quarter, effective_from, effective_through, payment_limit, dosage_descriptor, coinsurance_percentage, vaccine_awp_percent, vaccine_limit, blood_awp_percent, blood_limit, clotting_factor, notes, history, ndcs, status, effective_start, effective_end, replaced_by, on_date, in_effect, ndc_count, matched_ndcs, match_score (search results). | hcpcs,short_description,quarter |
Examples
curl
curl "https://api.healthcare.dev/v1/drugs/asp/J9271" \
-H "Authorization: Bearer $HDEV_API_KEY"TypeScript
const res = await fetch("https://api.healthcare.dev/v1/drugs/asp/J9271", {
headers: { Authorization: `Bearer ${process.env.HDEV_API_KEY}` },
});
const { data, meta } = await res.json();Python
import os
import requests
res = requests.get("https://api.healthcare.dev/v1/drugs/asp/J9271", headers={"Authorization": f"Bearer {os.environ['HDEV_API_KEY']}"})
body = res.json()Try it
Response
The payment limit, its history and crosswalked NDCs
{
"data": {
"hcpcs": "string",
"code_system": "hcpcs",
"short_description": "string",
"quarter": "string",
"effective_from": "2026-10-01",
"effective_through": "2026-10-01",
"payment_limit": 0,
"dosage_descriptor": "string",
"coinsurance_percentage": 0,
"vaccine_awp_percent": 1,
"vaccine_limit": 0,
"blood_awp_percent": 1,
"blood_limit": 0,
"clotting_factor": true,
"notes": "string",
"history": [
{
"quarter": "string",
"effective_from": "2026-10-01",
"effective_through": "2026-10-01",
"payment_limit": 0,
"dosage_descriptor": "string",
"coinsurance_percentage": 0,
"vaccine_awp_percent": 1,
"vaccine_limit": 0,
"blood_awp_percent": 1,
"blood_limit": 0,
"clotting_factor": true,
"notes": "string"
}
],
"ndcs": [
{
"ndc": "string",
"ndc11": "string",
"labeler": "string",
"drug_name": "string",
"hcpcs_dosage": "string",
"package_size": 1,
"package_quantity": 1,
"billing_units": 1,
"billing_units_per_package": 1,
"quarters": [
null
]
}
],
"status": "active",
"effective_start": "2026-10-01",
"effective_end": "2026-10-01",
"replaced_by": [
"string"
],
"on_date": "2026-10-01",
"in_effect": {
"quarter": "string",
"effective_from": "2026-10-01",
"effective_through": "2026-10-01",
"payment_limit": 0,
"dosage_descriptor": "string",
"coinsurance_percentage": 0,
"vaccine_awp_percent": 1,
"vaccine_limit": 0,
"blood_awp_percent": 1,
"blood_limit": 0,
"clotting_factor": true,
"notes": "string"
}
},
"meta": {
"source": "cms-icd10",
"data_version": "2026.1",
"retrieved_at": "2026-10-24T12:00:00Z",
"license": "Public domain (CMS). Reference data, not medical advice."
},
"links": {
"self": "/v1/drugs/asp/J9271",
"next": null
}
}Fields
| Field | Type | Always present | Description |
|---|---|---|---|
hcpcs | string | yes | Billing code: HCPCS Level II (e.g. J9271), or a CPT code number for vaccines |
code_system | "hcpcs" | "cpt" | yes | cpt for CPT code numbers (vaccines, immune globulins): their descriptors are © AMA and never included |
short_description | string | null | yes | CMS's HCPCS Level II short descriptor; always null for CPT codes |
quarter | string | yes | Calendar quarter, as its first month (2026-10 = October to December 2026) |
effective_from | string (date) | yes | First day the payment limit applies |
effective_through | string (date) | yes | Last day the payment limit applies (inclusive) |
payment_limit | number | null | yes | Medicare Part B payment allowance limit, USD per dosage_descriptor unit (generally 106% of ASP); null where CMS lists none (N/A) |
dosage_descriptor | string | null | yes | The billing unit the limit is per, as CMS lists it, e.g. 10 MG, 1 ML |
coinsurance_percentage | number | null | yes | Beneficiary coinsurance, percent (20 unless reduced, e.g. inflation-adjusted coinsurance) |
vaccine_awp_percent | number | null | yes | Vaccines priced at a percent of AWP |
vaccine_limit | number | null | yes | |
blood_awp_percent | number | null | yes | Blood products priced at a percent of AWP |
blood_limit | number | null | yes | |
clotting_factor | boolean | yes | Clotting factor: the separate furnishing fee applies on top of the limit |
notes | string | null | yes | CMS's note, e.g. Added October 2026 |
history | AspQuarter[] | yes | Every quarter in the files loaded (about two years), newest first; the newest is also flattened above. The limit in effect on a date is the entry whose effective_from..effective_through contains it. |
ndcs | AspNdc[] | yes | NDCs the ASP NDC-HCPCS crosswalk assigns to this code in any quarter loaded |
status | "active" | "retired" | "replaced" | yes | |
effective_start | string (date) | yes | |
effective_end | string | null (date) | yes | |
replaced_by | string[] | no | |
on_date | string (date) | yes | The date in_effect answers for (?date=, default today, UTC) |
in_effect | object | null | yes | The quarter whose payment limit applies on on_date, or null when no loaded quarter covers it (a future date before CMS posts that quarter, or a date older than the history kept) |
Errors
Errors are application/problem+json (RFC 9457). Branch on type, not on title. See Errors.
| Status | type | When |
|---|---|---|
| 400 | invalid-request | A parameter or the body failed validation; errors lists each field. |
| 401 | unauthorized | Missing, malformed or revoked API key. |
| 404 | not-found | No record with that id (retired records are still returned). |
| 429 | rate-limited / quota-exceeded | Too many requests per second (retry after Retry-After), or the monthly quota is used up. |
| 503 | dataset-unavailable / unavailable | The dataset has no published version yet, or the service is degraded. |