The short answer
CHAMPVA has no network, so any licensed therapist, counselor, social worker, psychologist, or psychiatrist can see you if they're willing to bill CHAMPVA. Ask whether they bill payer ID 84146 and accept assignment. Routine outpatient therapy doesn't need a referral. After your deductible, you usually pay 25% of CHAMPVA's allowable amount per session.
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Can any therapist take CHAMPVA?
Almost. VA says there's no specific network of CHAMPVA providers. A therapist doesn't sign up, join, or credential with CHAMPVA. Under 38 CFR 17.270, they need to be licensed or certified by the state to provide the care, and working within that license.
That usually includes:
- licensed clinical social workers (LCSW),
- licensed professional counselors or mental health counselors (LPC, LMHC),
- licensed marriage and family therapists (LMFT),
- psychologists,
- psychiatrists, and
- psychiatric nurse practitioners.
The CHAMPVA Guidebook says outpatient therapy has to come from a provider type CHAMPVA recognizes. If your therapist has a less common license, have them call CHAMPVA at 800-733-8387 to confirm. More here: What counts as an authorized CHAMPVA provider?
What should you ask a therapy office?
The person answering the phone usually checks a list of insurance networks. CHAMPVA won't be on it. So ask about billing instead:
"Hi, I'm looking for a therapist and I have CHAMPVA. It's not a network plan, so I'm not asking if you're in network. Does your practice bill CHAMPVA under payer ID 84146? If you're not sure, could you check with whoever does your billing? And do you accept CHAMPVA assignment?"
If they say yes, ask about openings, whether they offer video sessions, and whether the therapist has experience with military families, if that matters to you.
Where should you look?
- Practices that take Medicare and TRICARE. They're usually already set up for CHAMPVA. Medicare's search and TRICARE's search are good starting lists.
- Practices that work with military families. They're more likely to know CHAMPVA.
- Your current doctor. Ask who they refer to.
For the general provider search, see How to find a provider that takes CHAMPVA.
Do you need a referral or approval?
Not for routine outpatient therapy. CHAMPVA doesn't require a referral to see a therapist. The old 23-visit limit is gone, and regular weekly therapy isn't on the preauthorization list in 38 CFR 17.273.
Higher levels of care are different. Intensive outpatient programs, partial hospitalization, residential treatment, and non-emergency inpatient care need approval first. VA's provider page words this broadly, so if an office is unsure, they can call 833-930-0816 and ask. More here: CHAMPVA mental health coverage.
What will each session cost?
If CHAMPVA is your only coverage, you pay your deductible first ($50 per person, $100 per family each year), then 25% of CHAMPVA's allowable amount.
Example, with a made-up allowable amount of $120 for a session:
| Session | You pay | CHAMPVA pays |
|---|---|---|
| First session of the year | $50 deductible + 25% of $70 = $67.50 | $52.50 |
| Each session after that | 25% of $120 = $30 | $90 |
Your real numbers depend on the service and location. Your family's total yearly deductibles and cost shares stop at $3,000. More here: CHAMPVA cost share.
If you have other insurance, it pays first and you may owe less.
Is online therapy covered?
Yes, when the therapy is covered and the therapist is licensed where you are. Video and phone sessions can widen your options a lot, especially in rural areas. More here: CHAMPVA telehealth.
What if your therapist doesn't bill insurance?
You can still use CHAMPVA. Pay the therapist, then file a claim for reimbursement with an itemized receipt (sometimes called a superbill). CHAMPVA reimburses based on its allowable amount, not the therapist's fee, so expect to get back less than you paid. More here: Who files the CHAMPVA claim?
What if you can't find anyone nearby?
- Widen your search to telehealth therapists licensed in your state.
- Ask practices that take Medicare and TRICARE, even if they don't list CHAMPVA.
- Check whether a nearby VA facility offers mental health care to CHAMPVA family members through CITI. More here: CHAMPVA CITI.
- Look at Vet Centers. Some offer counseling to family members.
What we see in practice
The most common reason people think a therapist doesn't take CHAMPVA is that they asked the wrong question. The people who check coverage at a therapy office are usually trained to look up which insurance networks the practice belongs to. CHAMPVA isn't a network plan, so it won't be on that list, and you'll hear "we don't take CHAMPVA" even from practices that do bill it.
Ask whether they bill to payer ID 84146, and if the person you're talking to isn't sure, ask them to check with billing. A good starting point: practices that take Medicare and TRICARE are very likely already set up to take CHAMPVA.