{"data":{"id":"us/38-cfr-17.273","jurisdiction":"us","citation":"38 CFR 17.273","heading":"Preauthorization.","body":"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):\n(a) Non-emergent inpatient mental health and substance abuse care including admission of emotionally disturbed children and adolescents to residential treatment centers.\n(b) All admissions to a partial hospitalization program (including alcohol rehabilitation).\n(c) Dental care. For limitations on dental care, see § 17.272(a)(21)(i) through (xii).\n(d) Organ transplants.\n(e) CHAMPVA will perform a retrospective medical necessity review during the coordination of benefits process if:\n(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,\n(2) The claim for payment is filed within the appropriate one-year period.","path":["Title 38—Pensions, Bonuses, and Veterans' Relief","CHAPTER I—DEPARTMENT OF VETERANS AFFAIRS","PART 17—MEDICAL"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-38.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:25:50Z","sha256":"1b9d2ad830417ae2433d2fcb5d067a91d1904a372341b86d0a1938e5e4589622","source_id":"us-cfr","stale":true,"prev":"us/38-cfr-17.272","next":"us/38-cfr-17.274"},"notice":"GroundRules: Original legal text. Not legal advice."}