No enrollment. No contracts. Standard forms. A plain-language guide for treating and billing CHAMPVA beneficiaries.
CHAMPVA โ the Civilian Health and Medical Program of the Department of Veterans Affairs โ is a federal health benefit for eligible dependents and survivors of certain disabled or deceased veterans. It is administered by the VA Health Administration Center (HAC) in Denver, Colorado.
CHAMPVA is not TRICARE (which serves active-duty military and their families). Most providers who don't accept it simply don't know how straightforward it is to bill.
Ask the patient for their CHAMPVA Authorization Card. Call 1-800-733-8387 to confirm active eligibility. Note the beneficiary's ID number and the veteran sponsor's VA file number โ you'll need both on the claim.
CHAMPVA is secondary to all other health insurance except Medicaid. If the patient has Medicare or a commercial plan, bill that plan first and collect the EOB.
Use CMS-1500 (professional) or UB-04 (institutional). Include: veteran sponsor VA file number (Box 1a), beneficiary date of birth and relationship, your NPI, ICD-10 codes, CPT/HCPCS codes, dates and place of service, charges, and primary EOB if secondary.
Electronic (preferred): Through your clearinghouse โ ask them to add VA HAC as a payer.
By mail: VA Health Administration Center, PO Box 469064, Denver, CO 80246-9064
Timely filing: 1 year from date of service (or 1 year from primary EOB if secondary).
VA HAC sends an EOB with payment. CHAMPVA pays at its allowable rate โ generally similar to Medicare allowables. If denied, the EOB specifies the reason and appeal process.
| Item | Details |
|---|---|
| Claims mailing address | VA Health Administration Center PO Box 469064, Denver, CO 80246-9064 |
| Beneficiary services phone | 1-800-733-8387 (MโF, 8amโ4:30pm MT) |
| Website | va.gov/CHAMPVA |
| Electronic payer ID | Varies by clearinghouse โ contact your clearinghouse to add VA HAC as a payer. |
| Claim forms | CMS-1500 (professional) ยท UB-04 (institutional) |
| Timely filing | 1 year from date of service ยท 1 year from primary EOB date (if secondary) |
| Prior authorization | Not required for most services. Required for organ transplants and select procedures. |
| Allowable rates | Generally based on Medicare fee schedule rates |