38 CFR § 17.273 - Preauthorization.

---
identifier: "/us/cfr/t38/s17.273"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "38 CFR § 17.273 - Preauthorization."
title_number: 38
title_name: "Pensions, Bonuses, and Veterans' Relief"
section_number: "17.273"
section_name: "Preauthorization."
chapter_name: "DEPARTMENT OF VETERANS AFFAIRS"
part_number: "17"
part_name: "MEDICAL"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "38 U.S.C. 501, and as noted in specific sections."
cfr_part: "17"
---


# 17.273 Preauthorization.

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):

(a) Non-emergent inpatient mental health and substance abuse care including admission of emotionally disturbed children and adolescents to residential treatment centers.

(b) All admissions to a partial hospitalization program (including alcohol rehabilitation).

(c) Dental care. For limitations on dental care, see § 17.272(a)(21)(i) through (xii).

(d) Organ transplants.

(e) CHAMPVA will perform a retrospective medical necessity review during the coordination of benefits process if:

(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) The claim for payment is filed within the appropriate one-year period.

[63 FR 48102, Sept. 9, 1998, as amended at 74 FR 31374, July 1, 2009; 87 FR 41601, July 13, 2022; 89 FR 34137, Apr. 30, 2024]