The U.S. Department of Veterans Affairs (VA) has published the calendar year (CY)
2026 VA Fee Schedule that is effective for services furnished from January 1, 2026, through December 31, 2026.
While most community nursing home services under contract or provider agreements are paid using a bundled payment model, including the VA PDPM model, several services may be reimbursed separately, such as physician services and nursing aide escort services for medical appointments during a nursing home stay. Additionally, physical and occupational therapy (PT/OT) and speech-language pathology (SLP) services furnished to veterans with long nursing home stays of more than 100 days are reimbursed on a per-procedure basis. Typically, these services require prior authorization.
VA uses time-based HCPCS codes rather than commonly used CPT codes that are used for Medicare Part B therapy services. For AHCA member convenience, we have posted a member’s-only VA therapy and escort services fee schedule file for CY 2026 on our
Reimbursement Resources webpage.