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Payer Rates and Charges

Reasonable Charges are based on amounts that third parties pay for the same services furnished by private-sector health care providers in the same geographic area. In the past, VA used average cost-based, per diem rates for billing insurers. Reasonable charges are calculated for inpatient and outpatient facility charges, and for professional or clinician charges for inpatient and outpatient care.

Reasonable Charges Rules, Notices, & Federal Register (PDF | Web)
Reasonable Charges Data Tables (Excel)

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Reasonable Charges Data Sources (Excel | PDF)

Excel files

PDF documents

VA Medical Facility Locations (PDF)
Cost-Based and Interagency Rate (PDF | Web)

Third Party Pharmacy Prescription Administrative Charge

Average national administrative cost for prescriptions can be viewed at the Average Administrative Cost for Prescriptions webpage.

Average Administrative Cost for Prescriptions

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