CHAMPVA payment

What does CHAMPVA pay?

In most cases, CHAMPVA pays equivalent to Medicare/TRlCARE rates. CHAMPVAhas an outpatient deductible ($50 per person up to $100 per family per calendar year)and a cost share of 25%. You should collect the 25% allowable cost share from thepatient except when the patient has other health insurance.If the beneficiary has other health insurance, then CHAMPVA pays the lessor ofeither 75% of the allowable amount after $50 calendar year deductible is satisfied, orthe remainder of the charges and the beneficiary will normally have no cost share.

How fast does CHAMPVA pay?

CHAMPVA normally pays 95% of claims within 30 days.
Are there special considerations for Ambulatory Surgery Centers?Yes, they must have Medicare approval to
perform the specific procedure at freestandingsurgical centers.

For More information

Mail: VA Health Administration Center
Denver, CO 80206-9023Phone: 1-800-733-8387
FAX: 1-303-331 -7804

Medicare payment
CHAMPVA claims address

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