The short answer
Your VA care team sends a referral for therapy to a community provider, and VA issues an authorization for a set period and set of services. Outpatient mental health and family or couples therapy now get one-year authorizations. When sessions or time are running out, your therapist sends VA a Request for Service, VA Form 10-10172, before the end date.
How does a Community Care therapy referral work?
It follows the same steps as any Community Care referral:
- You qualify. Most often because VA can't see you within 20 days or a 30-minute average drive, or because Community Care is in your best medical interest. See Mental Health Access Rules.
- You ask your VA team for therapy through Community Care, and name a therapist if you have one.
- VA prepares a referral, which VA says can take up to 14 days, and sends it to the therapist.
- VA issues an authorization with a number, the approved provider, the type of care, and how long it lasts.
- You schedule, or VA does. See Scheduling Your Own Appointment.
How long does a therapy authorization last?
Often a year. In August 2025, VA announced one-year authorizations for 30 types of care, including Mental Health Outpatient, Family and Couples Psychotherapy Outpatient, Addiction Psychiatry Outpatient, and Addiction Medicine Outpatient. That's the regulatory maximum: 38 CFR 17.4005 limits an episode of care to one calendar year.
Check your letter, though. An authorization can also have a visit limit, and it only covers the services in the Standardized Episode of Care (SEOC), the standard package of services VA approved.
How do I get more sessions?
Your therapist asks VA with a Request for Service (RFS), VA Form 10-10172. VA's RFS page says providers use it for more visits or time, such as when an authorization is about to expire.
To be complete, the RFS needs:
- the therapist's signature and date;
- supporting records, like recent notes and a treatment plan showing why therapy should continue; and
- one form per request.
VA says it processes requests within 3 business days. Requests missing records or a signature are denied.
How do I avoid a gap in therapy?
Weekly therapy can use up an authorization faster than people expect. To keep sessions going:
- Know your numbers. Note your end date and any visit limit when you get the letter.
- Ask early. About a month or two before the end date, or several sessions before the limit, ask your therapist: "Have you sent VA a Request for Service to extend my authorization?"
- Follow up. If VA hasn't answered within a few business days, ask your therapist to call the VA Community Care office, or call it yourself.
- Don't keep going past the end date without approval, unless your therapist has confirmed VA extended it.
What if my therapist wants to add something new?
An authorization for therapy doesn't automatically cover psychiatry, psychological testing, couples sessions under a different SEOC, or an intensive program. Each needs its own approval through an RFS. See Psychiatry and Medication Management Referrals and Why Your Authorization Doesn't Cover Everything.
Can I keep the same therapist when the authorization renews?
Usually, yes. An RFS for more time goes to the same provider. If VA questions continuing outside care, continuity with a therapist you're doing well with is a best medical interest factor. See Keeping Your Current Therapist.
What if VA denies the extension?
Ask why. If it was denied for missing records, your therapist can resubmit with them. If VA decided you no longer qualify for Community Care, ask for that decision in writing. You can appeal through VA's clinical appeals process. See Appealing a Mental Health Community Care Denial.