Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

Community Care

Quick Links
Veterans Crisis Line Badge
My healthevet badge

VA Fee Schedule

VA reimburses hospital care, medical services and extended care services up to the maximum allowable rate. Generally, the applicable Medicare rate published by the Centers for Medicare and Medicaid Services (CMS). When there is no Medicare rate available, VA reimburses the lesser of the VA Fee Schedule or billed charges. When there is no Medicare rate available, the VA Fee Schedule dictates the maximum allowable rate for Community Care Network (CCN) providers. In the event a Medicare or VA Fee Schedule rate is not available, third party administrators (TPAs) reimburse a percentage of billed charges.

Please note:

  • Alaska providers have unique considerations covered in the section below.
  • Dental reimbursement rates are proprietary and not publicly available.
  • Reimbursement rates are subject to change. Check this page regularly to find the latest rates, and sign up for the VA Provider Advisor newsletter to be informed of rate updates.

    Sign up for the Provider Advisor newsletter
2024 Fee Schedule

The CY24 VA Fee Schedule linked below is effective February 1, 2024 – January 31, 2025.

CY24 VA Fee Schedule-All Payers

Which rate applies to me?

  1. Open the CY24 VA Fee Schedule-All Payers file above.
  2. Identify the service to include modifier (if applicable).
  3. Identify the Medicare locality and carrier for the location where services were rendered.
    • Providers needing assistance with identification of locality and carrier information are encouraged to refer to the appropriate CMS locality and carrier key available at the website.

Centers for Medicare & Medicaid Services

  1. Identify the setting in which care was rendered
    • For care rendered in a facility setting, refer to the ‘Yes’ column for reimbursement rate.
    • For care rendered in a setting other than a facility, refer to the ‘No’ column for reimbursement rate.
Alaska Providers

Certain community services provided to Veterans in the state of Alaska are subject to specific fee schedules. These account for the unique cost of providing care in that geographic area.

CCN is the preferred national network for purchasing care for Veterans in the community. Care referred to CCN in Alaska is billed to and paid by TriWest, a VA regional third-party administrator. Care referred outside of CCN is billed to and paid by VA.

Please refer to the VA referral for information on how the Veteran's care was referred and where to submit claims. Schedules and payment rates may be impacted depending on whether the care was approved through CCN. Please refer to the terms of your contract for information related to schedule usage.

VA will increase the amounts on the VA Alaska Fee Schedule annually in accordance with the published national Medicare Economic Index. For those years where the annual average is a negative percentage, the fee schedule will remain the same as the previous year.

2024 Alaska Professional Fee Schedule (Effective for services on or after Jan. 1, 2024)

2024 Alaska VA Fee Schedule (Effective for services on or after Feb. 1, 2024)

Community Nursing Home (CNH) Fee Schedule (effective Oct. 1, 2023)

The VA CNH Fee Schedule follows the Prospective Payment System (PPS) billing requirements found in "Chapter 6–Skilled Nursing Facility (SNF) Inpatient Part A Billing and SNF Consolidated Billing," Medicare Claims Processing Manual, with some exceptions. This includes VA paying the lesser of billed charges or the CNH Fee Schedule, the interrupted stay policy and enhanced payments for HIV/AIDS. Exceptions are listed below.

Medicare Claims Processing Manual, Chapter 6


  1. VA will use the Patient Driven Payment Model-based (PDPM) pricing software using the following specifications:
    1. CNH day 1-100: multiply physical therapy (PT), occupational therapy (OT), speech language pathology (SLP), nursing, and non-case-mix components by 0.93 in addition to any other adjustment factors.
    2. CNH day 101+: remove PT, OT, and SLP components (or set adjustment factor to 0). Multiply nursing and non-case-mix components by 1.25.
    3. The non-therapy ancillary component will follow PDPM (3.0 for the first three days, 1.0 for CNH day 1-100, and 1.25 for CNH day 101+).
  2. No special service pricing exists outside of VA PDPM-based PPS for services such as bed hold, memory care, behavioral, HIV/AIDS, respite, ventilator, tracheostomy, and isolation/private room.
  3. VA does not participate in the sequestration, quality reporting, or in the value based program.
  4. VA covers some services under CNH authorizations that are not considered part of the nursing home PPS, listed below. Nursing homes are required to submit separate claims for these services.
    1. Physician services: Providers delivering federally mandated or separately authorized services shall bill fee-for-service. The services will be reimbursed at the lesser of billed charges or the Medicare Physician Fee Schedule. Nursing facilities are required to make claims on behalf of the physician, unless the physician has a Veterans Care Agreement with VA.
    2. PT, OT and SLP: When PT, OT or SLP therapy is required during days 101+ of a Veteran’s stay, providers must get prior authorization from VA. When care is delivered on days 101+ of a Veteran’s stay, providers will bill fee-for-service using the following procedure codes: G0151, G0152, G0153, G0157, G0158, G0159, G0160, G0161. The services will be reimbursed at the lesser of billed charges or the VA Fee Schedule.
    3. Escort services: When an escort to a medical appointment is indicated, providers must get prior authorization from VA. Providers will bill fee-for-service using the following procedure code: G0156. The services paid will be the lesser of billed charges or the VA Fee Schedule.
Historical Fee Schedules

2023 Fee Schedules

*VA adjusted the yearly fee schedule update cycle to ensure rate settings consider comprehensive data from other sources. Beginning in 2023, the fee schedule cycle runs Feb. 1 to Jan. 31. To accommodate the adjustment, the CY22 VA Fee Schedule–All Payers service dates will run through Jan. 31, 2023.

2022 Fee Schedules

2021 Fee Schedules

VA Fee Schedule Data Definitions
  • Facility: The service is performed in a facility setting (i.e., hospital, ambulatory or surgical center)
  • Facility type: A hospital or other institution where outpatient and inpatient services are performed
  • Locality Description: Name of locality place of service (e.g., city, county)
  • Medicare Carrier: The identification number assigned by CMS to a carrier (Medicare Administrative Contractor) authorized to process claims from a physician or supplier
  • Medicare Locality: The identification number assigned by CMS to a locality used to identify where care is rendered
  • Non-Facility: The service is performed in a non-facility setting (i.e., physician’s office or outpatient clinic)
  • Procedure: Current Procedural Terminology/ Healthcare Common Procedure Coding System Industry standard codes used to identify specific surgical, medical, or diagnostic intervention
  • Procedure Code Modifier: Supplemental information or adjust care descriptions to provide extra detail concerning a procedure or service
  • Rate: Reimbursement amount based on where care is rendered

Contact Us

TriWest Customer Service: 877-226-8749

Optum Customer Service:
CCN Region 1: 888-901-7407
CCN Region 2: 844-839-6108
CCN Region 3: 888-901-6613

VA Customer Service: 877-881-7618