News & Press: General News

Info for Those Currently Contracted or Interested in Contracting to Provide VA Covered Services

Wednesday, January 29, 2020   (0 Comments)
Posted by: Alyse Meyer
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VA recently released its Fee Schedule for Fiscal Year (FY) 2019 (beginning October 1, 2019) for all medical and extended/long-term care services.

This document contains the rates for adult day services (procedure codes S5100, S5101, S5102) by state and by VAMC. Rates are available at 15 minute, half day and/or full day intervals, depending on the VA Medical Center (VAMC).

The FY 2019 Fee Schedule can be downloaded in full at this link. The Fee Schedule contains the rates providers will be paid under the Community Care Networks that Optum and TriWest are operating. TriWest is the health plan operating in Texas. Click here to view the rates for all VAMCs for adult day services.

Per the Fee Schedule Document, these rates are “effective for dates of service beginning October 1, 2019 for claims processed after November 7, 2019 and will be updated by the VA annually.  Claims processed prior to November 8, 2019 will not be re-adjudicated.”

As the Mission Act rolls out we will be bringing more information to members. In addition to previously covered benefits, non-skilled home health, respite, adult day and more are rolling into the TriWest CCN presenting more opportunity for our members. 

For more information, please click here