VA Fee Schedule - Community Care
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

Menu
Menu

Quick Links

Veterans Crisis Line Badge
My healthevet badge
EBenefits Badge
 

VA Fee Schedule

This webpage contains reimbursement rates for inpatient and outpatient health care professional services subject to the Department of Veterans Affairs (VA) Fee Schedule.

For inpatient and outpatient health care professional services and other medical charges covered by a Veterans Care Agreement (VCA), VA reimburses at the applicable Medicare rate published by the Centers for Medicare and Medicaid Services (CMS). When there is no Medicare rate and there is a VA Fee Schedule amount available, VA reimburses at the lesser of billed charges or the local VA Fee Schedule amount for the period in which the service was performed.

NOTE: In accordance with the terms of VA’s contract for compiling a dental services fee schedule, said schedule is not publicly available.

The VA Fee Schedule amount is determined by analyzing provider billings within specific localities, which ranks all billings (if the facility has had at least eight billings) from non-VA facilities under the corresponding procedure code during the previous fiscal year, with billings ranked from the highest to the lowest. The VA Fee Schedule amount is the charge falling at the 75th percentile. If the authorizing VA medical facility has not had at least eight such billings, then this paragraph does not apply.

Updated fee schedules will be published quarterly. Below are links to download the current schedule along with archived schedules as new versions are released.

VA Fee Schedule Data Definitions

  • VA VISN: Veterans Affairs Veterans Integrated Service Network
  • Station Number: VA numerical identifier for a specific VA location
  • Facility Name: Geographic location of VA facility
  • CPT Code: Industry standard codes, some including modifiers
  • Rate: Location specific VA reimbursement rate
  • Fiscal Year: Fiscal year for which rates are applicable

Current Year Fee Schedules (rates effective 10/01/19)

Current FY20 National Fee Schedule, posted 19 March 2020

Archived/Previous Fee Schedules

FY20 National Fee Schedule–OCT 2019

Frequently Asked Questions

How do I download the Fee Schedule files?

Right click on the Fee Schedule link and select save. Then save the file to a location on your computer.

Which services are included in this fee schedule?

This schedule includes rates for physician, clinical laboratory, ambulance, and drug services.

How do I determine which locality applies to me?

Rates are specific to geographic locations. To find applicable rates for authorized care, providers should locate the authorizing facility in the fee schedule. For unauthorized/emergent care, providers should locate the nearest VA facility to where the emergenct occurred using the VA Facility Locator tool.

VA Facility Locator

How often will VA publish an updated fee schedule version?

VA will publish an updated fee schedule four times per year: January, April, July, and October.

Resources