The short answer
There's no network to join or contract to sign. If you're licensed for the service, you can treat CHAMPVA clients. Verify eligibility before the first visit, check whether preauthorization applies, decide whether to accept assignment, enroll in VA's electronic funds transfer, and send claims to payer ID 84146.
Do you have to join a network to accept CHAMPVA?
No. CHAMPVA doesn't have a provider network. VA's family member care page says providers don't need to join the Community Care Network or sign a Veterans Care Agreement to treat CHAMPVA patients. If you're licensed for the service and working within scope, you're an authorized provider.
That's the good news. The work is in setting up a clean billing routine.
What are the steps?
- Enroll in EFT. VA pays family member program claims only by electronic funds transfer. Submit VA Form 10091 through VA's Financial Services Center portal before your first claim. See CHAMPVA EFT Enrollment.
- Verify eligibility before each new client. Send an electronic 270 inquiry to payer ID VAHAC, or call 888-820-1756 (24/7). A CHAMPVA card alone doesn't prove active coverage.
- Ask about other insurance. CHAMPVA pays after most other health insurance, so bill that plan first.
- Check preauthorization. Routine outpatient therapy isn't on the preauthorization list in 38 CFR 17.273 or the CHAMPVA Guidebook. But VA's provider page says most mental health services need it, so call 833-930-0816 if you're unsure.
- Decide on assignment. Accepting assignment means you take CHAMPVA's allowable amount as payment in full, minus the client's deductible and cost share. See Assignment and Balance Billing.
- Bill electronically to payer ID 84146 through VA's clearinghouse.
The full checklist is in the CHAMPVA Provider Quick Start.
What does it pay?
CHAMPVA pays its allowable amount, which is generally based on Medicare-style rates under 38 CFR 17.275. After the client's annual deductible, CHAMPVA usually pays 75% of the allowable amount and the client owes 25%. See CHAMPVA Allowable Amount.
Why don't more therapists take CHAMPVA?
Mostly unfamiliarity. It doesn't run like commercial insurance: no network, separate payer IDs for eligibility and claims, EFT-only payment, and other-insurance rules that trip people up. Once the routine is set, it's manageable. But families often struggle to find a therapist who takes it.
How ValorWell handles this
ValorWell handles CHAMPVA billing for its therapists: eligibility, other-insurance coordination, preauthorization checks, claims, and denials. You treat the client and complete your notes. You're paid weekly for sessions you documented that pay period, and denied claims don't come out of your pay.
If you'd rather keep CHAMPVA clients in your own practice, the steps above are what it takes. ValorWell is nonexclusive, so you can do both.
Important limits
- Eligibility is VA's decision. Verify every client, every time coverage might have changed.
- CHAMPVA isn't TRICARE. Many families mix them up. See CHAMPVA vs. TRICARE vs. VA Community Care.
- Clients 65 and older usually have Medicare first. Medicare pays before CHAMPVA, which affects whether you can bill. See Medicare for LPCs and LMFTs.
- Rules change. Check VA's CHAMPVA provider page for current phone numbers and payer IDs.