Ocrevus is Genentech's brand name for ocrelizumab, an anti-CD20 monoclonal antibody that depletes B-cells implicated in multiple sclerosis nerve damage. The FDA approved Ocrevus in March 2017 for relapsing forms of MS and primary progressive MS, making it the first drug approved for the progressive form of the disease. Ocrevus Zunovo, a subcutaneous version combined with hyaluronidase, followed with FDA approval in September 2024 and is given as a single 10-minute injection instead of a 2-hour IV infusion. Both versions use the same ocrelizumab molecule and carry the same 2026 list price.
Genentech lists Ocrevus at approximately $78,858 per year in 2026, calculated from two maintenance infusions of 600 mg given six months apart. The first year of treatment costs slightly less per infusion because the initial course is split into two 300 mg loading infusions given two weeks apart, followed by the first 600 mg maintenance dose six months later. What a patient actually pays depends heavily on whether the infusion happens in a hospital outpatient department, a freestanding infusion center, or a neurologist's office, since each site bills under a different facility structure even though the drug acquisition cost is identical.
Ocrevus is not one of the drugs the Inflation Reduction Act selected for Medicare price negotiation in either the 2026 or 2027 negotiation rounds. Biologics only become eligible for negotiation once they have been on the market at least 11 years, which for Ocrevus (approved 2017) would not occur until 2030 at the earliest, and CMS would still need to select it in a future round before any Maximum Fair Price applied. Patients comparing this timeline should also review how Medicare covers biologic infusions billed under Part B versus Part D, since the billing pathway determines which out-of-pocket cap, if any, applies to a given infused drug.
What Ocrevus Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same ocrevus can cost many times more at a hospital than at your local pharmacy:
2026 Ocrevus Price by Point of Pay| Where you pay | Typical cost | Notes |
|---|
| Medicare Part B ASP rate (J2350, 2026) | $59.60/mg | What Medicare pays per mg before the standard add-on; a 600 mg maintenance dose totals about $35,760 in drug cost alone |
| Medicare Part B coinsurance (after deductible, 2026) | 20% of the ASP-based charge, after the $283 Part B deductible | On a 600 mg maintenance infusion this is roughly $7,150 per infusion unless a Medigap or Medicare Advantage plan covers the coinsurance |
| Infusion center (self-pay, cash price) | $19,000 - $41,000/infusion | List price without insurance; varies by loading (300 mg) versus maintenance (600 mg) dose and specialty pharmacy |
| Commercial insurance (after prior authorization) | $0 - $1,500/infusion with the OCREVUS Co-pay Program applied | Prior authorization confirming relapsing or primary progressive MS diagnosis is standard; step therapy is common |
| Medicaid | $0 - $4/infusion, with prior authorization | Most state Medicaid programs cover ocrelizumab for FDA-approved MS indications with a nominal copay |
Medicare Part B ASP reflects the 2026 CMS ASP pricing file for J2350. Infusion-center cash prices reflect 2026 GoodRx and Rx.com specialty pharmacy survey data. Actual patient cost depends on site of care, plan formulary tier, and whether a facility bills at chargemaster or ASP-based rates.
Source: CMS Medicare Part B ASP Pricing Files 2026, Genentech OCREVUS Cost & Coverage page, GoodRx, Rx.com
Why Hospitals Charge So Much
Hospital outpatient departments bill Ocrevus infusions using a chargemaster rate that bundles the drug acquisition cost with facility fees for the infusion chair, nursing supervision during the 2-hour infusion (or 10-minute Ocrevus Zunovo injection plus a required 1-hour observation period), pre-medications like diphenhydramine and methylprednisolone, and overhead. At the Medicare ASP rate of $59.60 per mg, a 600 mg maintenance dose costs approximately $35,760 for the drug alone. Hospital chargemaster rates for the same infusion frequently list at $45,000 to $95,000, a markup driven by the facility fee structure rather than the drug's actual acquisition cost.
Freestanding infusion centers and neurologists' offices typically bill closer to the ASP-plus-add-on rate that Medicare actually pays, which is why site of care matters enormously for an Ocrevus infusion. A patient billed at a hospital outpatient department for the same 600 mg dose can see a bill three to four times higher than the identical infusion delivered at an independent infusion center, even though Medicare's allowed reimbursement is set nationally by the ASP file regardless of where the infusion happens. Ask your neurologist's office whether an independent infusion center is available in your network before scheduling at a hospital.
If your bill shows an Ocrevus infusion at $60,000 or more, request an itemized statement and confirm the HCPCS code and unit count. J2350 (or J2351 for Ocrevus Zunovo) should show 600 units for a standard maintenance dose or 300 units for a loading dose. Compare the unit count times the 2026 ASP rate of $59.60 per mg against the total charge; anything charged well above the ASP-based Medicare allowable is a facility markup, not a reflection of what Genentech charges for the drug itself.
HCPCS J-Codes: What Appears on Your Bill
Ocrelizumab appears on infusion center and hospital bills under two HCPCS Level II J-codes depending on which formulation you receive. Both are public domain codes you can use to verify your bill:
HCPCS J-codes for Ocrevus| Code | Description | What to look for |
|---|
| J2350 | Injection, ocrelizumab, 1 mg (IV infusion formulation) | Used for standard IV Ocrevus infusions: 300 units for each loading dose infusion, 600 units for a maintenance dose. Verify the unit count matches your prescribed dose and that the per-unit price is close to the 2026 ASP rate of $59.60. |
| J2351 | Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq (Ocrevus Zunovo subcutaneous formulation) | Used for the single 920 mg subcutaneous injection given every 6 months. Should show 920 units billed. Confirm you were not also billed a separate infusion administration fee, since Ocrevus Zunovo is a 10-minute injection, not an infusion. |
These are public-domain HCPCS Level II codes published annually by CMS. CPT administration codes (for the infusion or injection procedure itself) are AMA-licensed and not listed here.
Source: CMS HCPCS Level II Coding, CMS Part B ASP Pricing Files 2026
Patient Assistance Programs
Genentech runs two separate patient assistance program tracks for Ocrevus, one for commercially insured patients and one for the uninsured or underinsured. Which one applies depends entirely on your insurance status, not your income, for the commercial track.
Patient assistance programs for Ocrevus| Manufacturer program | Cost / Benefit | How to apply |
|---|
| OCREVUS Co-pay Program | Reduces out-of-pocket cost to as little as $0 per infusion, up to $20,000 per calendar year in drug cost savings, plus up to $1,500 in administration-fee assistance the first year | ocrevus.com/patient/cost.html |
| Genentech Patient Foundation | Free Ocrevus for uninsured or underinsured US residents with household income at or below 500% of the federal poverty level | genentech-access.com |
| NeedyMeds Patient Assistance Directory | Directory listing for additional MS-specific foundations and co-pay relief funds | needymeds.org |
A manufacturer coupon like the OCREVUS Co-pay Program cannot be used by patients on Medicare, Medicaid, TRICARE, or VA benefits under the federal anti-kickback statute (42 U.S.C. Section 1320a-7b). If you have any government insurance, apply to the Genentech Patient Foundation instead, or ask about the National Multiple Sclerosis Society's Financial Assistance program.
Source: Genentech OCREVUS Access Solutions, NeedyMeds.org
Common Ocrevus Billing Errors
Ocrevus billing is complex because two different J-codes exist for two different formulations and dose sizes change between the loading and maintenance phase. Check for these issues before paying an Ocrevus bill:
- Wrong J-code: J2351 (Ocrevus Zunovo, subcutaneous) billed for a standard IV infusion, or J2350 (IV) billed for a Zunovo injection. Each code carries a different ASP and different administration billing.
- Unit count mismatch: a 300 mg loading infusion should bill 300 units of J2350; a 600 mg maintenance infusion should bill 600 units. A line showing 1,200 units for a routine maintenance visit likely double-bills the dose.
- Site-of-care markup: the same 600 mg dose billed at a hospital outpatient department chargemaster rate instead of the freestanding infusion center or physician office rate, inflating the bill 3 to 4 times over what Medicare's ASP-based allowable would be.
- Duplicate premedication or observation charges: pre-infusion diphenhydramine, methylprednisolone, and the required post-injection observation period for Ocrevus Zunovo are sometimes billed as separate, inflated line items on top of the drug and administration fee.
- OCREVUS Co-pay Program not applied at the infusion center billing cycle even though you enrolled. Confirm with the infusion center's billing coordinator that the copay card BIN/PCN was applied to your claim before you pay a large balance.
Frequently Asked Questions
Is there a generic or biosimilar for Ocrevus?
No. As of 2026, no ocrelizumab generic or biosimilar is FDA-approved. Ocrevus patents run through approximately March 2029 in the US. Celltrion's CT-P53 biosimilar candidate is in Phase 3 trials, but the earliest realistic US launch is 2029 or later. Patients seeking a lower-cost alternative would need to switch to a different brand-name anti-CD20 therapy, not a generic version of Ocrevus itself.
How do I apply for the Genentech Ocrevus patient assistance program?
Call OCREVUS Access Solutions at 1-844-627-3887 or visit genentech-access.com. Your neurologist's office submits the enrollment form with your prescription. You will need income documentation, proof of US residency, and proof of your insurance status. Uninsured or underinsured patients earning up to 500% of the federal poverty level qualify for the Genentech Patient Foundation, which supplies Ocrevus free of charge. Processing typically takes 5 to 10 business days.
Can I use the OCREVUS Co-pay Program if I have Medicare?
No. Federal anti-kickback law bars manufacturer copay cards, including the OCREVUS Co-pay Program, from being used by anyone with Medicare, Medicaid, TRICARE, or VA benefits. The co-pay program is limited to commercially insured patients and can reduce their cost to as little as $0 per infusion. If you have Medicare, apply to the Genentech Patient Foundation instead, which does not exclude government beneficiaries the same way.
What if my insurance denies coverage for Ocrevus?
Request the written denial notice with the specific reason, then have your neurologist file a formal appeal with MRI findings, EDSS score, and relapse history within the plan's deadline. If denied again, request a peer-to-peer review, then escalate to an external review through your state Department of Insurance or Medicare's independent reconsideration process. Apply to the Genentech Patient Foundation for a bridge supply while the appeal is pending.
Does the Inflation Reduction Act's Maximum Fair Price apply to Ocrevus?
No. Ocrevus was not selected in the 2026 or 2027 Medicare drug price negotiation rounds. Biologics only become eligible for negotiation 11 years after FDA approval, which for Ocrevus (approved 2017) would not occur until 2030 at the earliest. Because Ocrevus is billed under Medicare Part B rather than Medicare Part D, the $2,100 Part D annual out-of-pocket cap in 2026 also does not apply; instead, Part B beneficiaries pay standard 20% coinsurance.
What does Ocrevus cost without insurance per infusion in 2026?
Cash prices without insurance run about $19,000 for a single 300 mg loading dose vial up to roughly $41,000 for a 600 mg maintenance infusion (requiring two vials), depending on the specialty pharmacy and site of care. CVS Specialty, Walgreens Specialty Pharmacy, Costco Specialty Pharmacy, Kroger Specialty Pharmacy, and Accredo all price 300 mg vials between $18,900 and $20,900 in 2026 surveys. The annual list price for two maintenance infusions is approximately $78,858.
Do I qualify for the Genentech Patient Foundation?
You likely qualify if you are a US resident, uninsured or underinsured, have a valid Ocrevus or Ocrevus Zunovo prescription for an FDA-approved MS indication, and your household income is at or below 500% of the federal poverty level, which is $79,800 for a household of one or $165,000 for a household of four in 2026. Applications are also denied if you already have insurance that covers Ocrevus or if the enrollment form is incomplete.
What is the difference between Ocrevus and Ocrevus Zunovo?
Both contain the same ocrelizumab molecule and treat the same MS indications at the same 2026 list price. Ocrevus is given as a roughly 2-hour IV infusion in a clinic or infusion center. Ocrevus Zunovo, approved by the FDA in September 2024, combines ocrelizumab with hyaluronidase and is given as a single 10-minute subcutaneous injection in the abdomen, followed by a required observation period, making it faster but still requiring in-person administration.
