VA Fee Schedule - Community Care
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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: The rates in this fee schedule may not apply to care provided through contracts with VA’s Third Party Administrators.

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.

Current Year Fee Schedules

FY20 National Fee Schedule as of January 14, 2020

Archived/Previous Fee Schedules

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

  • CMS Fee Schedules
    Link to current and historical CMS fee schedules.
  • VA Fee Schedule Data Definitions
    Explanations of the headings and terms used in the VA Fee Schedule file.
  • Find VA Locations
    Resource for locating the nearest VA facility.