The short answer
Verify eligibility through payer ID VAHAC or by phone, bill any other insurance first, and send claims electronically to payer ID 84146. CHAMPVA pays its allowable amount minus the client's deductible and 25% cost share. Claims are generally due within one year of the date of service, and you must be enrolled in EFT to get paid.
How does CHAMPVA billing work for therapy?
Like a secondary-friendly government payer with its own IDs. Here's the short version for an outpatient psychotherapy practice:
| Step | What to use |
|---|---|
| Eligibility | 270/271 to payer ID VAHAC, or call 888-820-1756 |
| Preauthorization questions | 833-930-0816 |
| Claims | 837P to payer ID 84146 |
| Claim status | 276/277 through VA's clearinghouse |
| Payment | EFT only |
| Filing deadline | 1 year from date of service (38 CFR 17.276) |
These come from VA's CHAMPVA provider page. Detailed walk-throughs are in the CHAMPVA Provider Quick Start.
What will CHAMPVA pay, and what does the client owe?
CHAMPVA calculates an allowable amount for each service under 38 CFR 17.275. For outpatient care, the client first meets an annual deductible. After that, CHAMPVA pays 75% of the allowable amount and the client owes a 25% cost share, up to a yearly family cap. See Cost Share and Annual Deductible.
If you accept assignment, the allowable amount is your full payment. You can collect only the deductible and cost share from the client.
What about clients with other insurance?
CHAMPVA pays after other health insurance, with a few exceptions like Medicaid. Bill the other plan first, then send CHAMPVA the claim with the other plan's Explanation of Benefits attached. Missing other-insurance information is one of the most common reasons claims stall. See CHAMPVA and Other Health Insurance.
Does therapy need preauthorization?
Routine outpatient therapy isn't on the preauthorization lists in 38 CFR 17.273 or the CHAMPVA Guidebook. Intensive outpatient, partial hospitalization, residential, and inpatient care do need it. Because VA's provider page states broadly that most mental health services need preauthorization, call 833-930-0816 when in doubt. Since 2024, CHAMPVA no longer has fixed visit limits for outpatient mental health care.
What are the common denial reasons?
- Eligibility not active on the date of service.
- Other insurance not billed first, or EOB missing.
- Patient or provider data that doesn't match across the claim.
- Duplicate claims sent while the first is still pending.
- Filing after the deadline.
VA publishes its denial codes for family member claims. Check claim status before resubmitting. See Corrected and Resubmitted Claims.
How ValorWell handles this
For ValorWell therapists, all of the above is ValorWell's job: eligibility, other insurance, claims, status checks, corrections, and denials. Your part is the session and a complete note.
You're paid weekly for sessions you documented that pay period. If CHAMPVA denies a claim, ValorWell handles it, and it doesn't reduce your pay. If a documentation issue ever causes problems, ValorWell's first step is to adjust its system and add support, not to penalize you.
Important limits
- This page doesn't give rates. Allowable amounts vary by service code and location, and change over time.
- Not every service is covered. Assignment doesn't make an excluded service covered. See 38 CFR 17.272.
- Couples and family sessions have their own coverage questions. Confirm before billing them.
- Contact details change. Recheck VA's provider page before updating your billing system.