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CHAMPVA In-House Treatment Initiative (CITI)

icon CHAMPVA treatment facilityThe CHAMPVA In-house Treatment Initiative (CITI) is a voluntary program that allows treatment of beneficiaries of the Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVA) at Veterans Affairs medical centers (VAMCs) that have elected to participate in CITI.

Frequently Asked Questions

How do I know if the local VA medical facility participates in CITI?

To find out if your local VA medical center or clinic participates in CITI, please contact the facility directly. A link to a list of participating facilities with direct contact phone numbers is located in the RESOURCES section at the bottom of this page. You may also contact the VHA Office of Integrated Veteran Care (VHA IVC) via any of the methods listed on the contacts page.

Why doesn’t every VA medical facility participate in CITI?

CITI is designed to provide CHAMPVA beneficiaries with access to care in a VA facility after the facility has met the needs of their Veteran population. In some areas, Veterans' needs utilize the full capacity of the VA medical facility.

Are there eligibility requirements for the program?

Yes. Since the VA cannot bill Medicare for covered medical services, any CHAMPVA enrollee with Medicare is not eligible to participate in the CITI. If you become Medicare eligible, you must stop using CITI services and obtain your care from a Medicare provider. Your other health insurance (OHI) status may also impact eligibility for the CITI. A participating facility or the VA can provide you with additional information on CITI eligibility.

How do I enroll?

You may be asked to complete an application or a patient registration form by the participating medical facility. Each participating facility has access to the CHAMPVA computer system to check your eligibility and OHI status.

What services are covered under CITI?

Each participating VA medical facility determines what kind of services may be provided on a space available basis. This includes the availability of the VA pharmacy to fill prescriptions written by a VA physician. If the facility does not offer pharmacy services, it is still possible to use other CHAMPVA program services for your pharmacy needs. Please refer to the CHAMPVA Guide or Pharmacy Benefits for additional information on pharmacy options.

Can the availability of services change once I am in the program?

Yes. If the facility experiences a change in Veteran workload, they may decide to limit or discontinue CITI services. The facility will work with our office to provide you timely notification of necessary changes. We can assist you in finding other providers if you are no longer able to be treated at a CITI facility.

How much is the cost share under CITI?

There are no cost shares or deductibles for covered services received at a participating CITI facility.

What if the CITI facility is not able to provide necessary medical care?

If the participating facility determines you need medical services that are beyond their direct ability, they may refer you to a community health care provider. You will need to use your CHAMPVA benefits when receiving care from this provider. You will be responsible for your standard cost-share under the CHAMPVA program which is typically 25 percent of allowable charges up to $3,000 per year after a $50 annual deductible. The CITI facility will not be involved in payment for this care. The community provider should bill our office directly.


CHAMPVA Customer Call Center
Monday–Friday, 6:00 am – 7:30 pm. ET

Email: Ask VA (AVA)