StacksVerified U.S. regulatory reference

38 CFR §17.273

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
Preauthorization or advance approval is required for any of the following, except when the benefit is covered by the CHAMPVA beneficiary's other health insurance (OHI):
  1. (a)Non-emergent inpatient mental health and substance abuse care including admission of emotionally disturbed children and adolescents to residential treatment centers.
  2. (b)All admissions to a partial hospitalization program (including alcohol rehabilitation).
  3. (c)Dental care. For limitations on dental care, see § 17.272(a)(21)(i) through (xii).
  4. (d)Organ transplants.
  5. (e)CHAMPVA will perform a retrospective medical necessity review during the coordination of benefits process if:
    1. (1)It is determined that CHAMPVA is the responsible payer for services and supplies but CHAMPVA preauthorization was not obtained prior to delivery of the services or supplies; and,
    2. (2)The claim for payment is filed within the appropriate one-year period.