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
- Reasonable Charges V3.26 Federal Register Notice, 10/01/19 (Inpatient)
(V3.26 FR Web) - Reasonable Charges V3.25 Federal Register Notice, 01/01/19 (Outpatient and Professional)
(V3.25 FR Web) - Reasonable Charges V3.24 Federal Register Notice, 10/01/18 (Inpatient)
(V3.24 FR Web) - Reasonable Charges V3.23 Federal Register Notice, 01/01/18 (Outpatient and Professional)
(V3.23 FR Web) - Reasonable Charges V3.22 Federal Register Notice, 10/01/17 (Inpatient)
(V3.22 FR Web) - Reasonable Charges V3.21 Federal Register Notice, 01/01/17 (Outpatient and Professional)
(V3.21 FR Web) - Reasonable Charges V3.19 Federal Register Notice, 10/01/16 (Inpatient)
(V3.19 FR Web) - Reasonable Charges V3.18 Federal Register Notice, 01/01/16 (Outpatient and Professional)
(V3.18 FR Web) - Reasonable Charges V3.17 Federal Register Notice, 10/01/15 (Inpatient)
(V3.17 FR Web) - Reasonable Charges V3.16 Federal Register Notice, 01/01/15 (Outpatient and Professional)
(V3.16 FR Web) - Reasonable Charges V3.15 Federal Register Notice, 10/01/14 (Inpatient)
(V3.15 FR Web) - Reasonable Charges V3.14 Federal Register Notice, 01/01/14 (Outpatient and Professional)
(V3.14 FR Web) - Reasonable Charges V3.13 Federal Register Notice, 10/01/13 (Inpatient)
(V3.13 FR Web)
Reasonable Charges Data Tables
- V3.26 Data Tables (Inpatient)
- V3.25 Data Tables (Outpatient and Professional)
- V3.24 Data Tables (Inpatient)
- V3.23 Data Tables (Outpatient and Professional)
- V3.22 Data Tables (Inpatient)
- V3.21 Data Tables (Outpatient and Professional)
- V3.19 Data Tables (Inpatient)
- V3.18 Data Tables (Outpatient and Professional)
- V3.17 Data Tables (Inpatient)
- V3.16 Data Tables (Outpatient and Professional)
- V3.15 Data Tables (Inpatient)
- V3.14 Data Tables (Outpatient and Professional)
- V3.13 Data Tables (Inpatient)
Reasonable Charges Data Sources
- Reasonable Charges V3.26 Data Sources (Inpatient)
- Reasonable Charges V3.25 Data Sources (Outpatient and Professional)
- Reasonable Charges V3.24 Data Sources (Inpatient)
- Reasonable Charges V3.23 Data Sources (Outpatient and Professional)
- Reasonable Charges V3.22 Data Sources (Inpatient)
- Reasonable Charges V3.21 Data Sources (Outpatient and Professional)
- Reasonable Charges V3.19 Data Sources (Inpatient)
- Reasonable Charges V3.18 Data Sources (Outpatient and Professional)
- Reasonable Charges V3.17 Data Sources (Inpatient)
- Reasonable Charges V3.16 Data Sources (Outpatient and Professional)
- Reasonable Charges V3.15 Data Sources (Inpatient)
- Reasonable Charges V3.14 Data Sources (Outpatient and Professional)
- Reasonable Charges V3.13 Data Sources (Inpatient)
VA Medical Facility Locations
- VA Medical Facility Locations, V3.26 (OCT19)
- VA Medical Facility Locations, V3.25 (JAN19)
- VA Medical Facility Locations, V3.24 (OCT18)
- VA Medical Facility Locations, V3.23 (JAN18)
- VA Medical Facility Locations, V3.22 (OCT17)
- VA Medical Facility Locations, V3.21 (JAN17)
- VA Medical Facility Locations, V3.19 (OCT16)
- VA Medical Facility Locations, V3.18 (JAN16)
- VA Medical Facility Locations, V3.17 (OCT15)
- VA Medical Facility Locations, V3.16 (JAN15)
- VA Medical Facility Locations, V3.15 (OCT14)
- VA Medical Facility Locations, V3.14 (JAN14)
- VA Medical Facility Locations, V3.13 (OCT13)
Third Party Pharmacy Prescription Administrative Charge
Average national administrative cost for prescriptions for CY 2014 through CY 2019 can be viewed at Average Administrative Cost for Prescriptions.
Average Administrative Cost for Prescriptions
Cost-Based and Interagency Rates
- Cost-Based and Interagency Federal Register Notice, 10/01/19 | (Web)
- Cost-Based and Interagency Federal Register Notice, 08/28/18 | (Web)
- Cost-Based and Interagency Federal Register Notice, 08/29/17 | (Web)
- Cost-Based and Interagency Federal Register Notice, 07/07/16 | (Web)
- Cost-Based and Interagency Federal Register Notice, 11/04/14 | (Web)