How to Complete and Submit the VA Third Party Payer Precertification Form

The VA Third Party Payer Precertification Form is submitted online through the VA Precertification Portal, not on paper. Community care providers use it to notify VA Revenue Operations before delivering certain services that the VA will bill to a veteran’s private health insurer. One quick clarification before you look for a form number: the “VA Form 10-0388” often cited in connection with this process actually belongs to the State Home Construction and Acquisition Grants series. The precertification document itself is an unnumbered PDF, and as of 2026 the VA requires submissions through the portal rather than by fax, email, or mail.¹

When Precertification Is Required

Precertification applies when a community provider delivers care under a VA-authorized referral for a condition unrelated to a service-connected disability, and the VA intends to bill the veteran’s private insurance for the reasonable cost. Not every authorized service triggers the requirement. The VA publishes a Standardized Episodes of Care (SEOC) Billing Code List identifying the codes that do, but the portal itself is the authoritative check: enter the HCPCS or CPT code and it will tell you whether precertification applies.¹

Urgent and emergency care are exempt entirely. CHAMPVA services follow a separate approval pathway and are not handled through this portal. Services that fall outside the scope of the original referral require additional VA approval through the Request for Service (RFS) process, not precertification.¹

What to Gather Before You Log In

Have these ready:

The veteran’s full name and identifying information as it appears in VA records.
The VA authorization number from the referral.
The HCPCS or CPT codes for the planned services.
Medical documentation supporting the clinical necessity of the service, ready to upload.

You do not need the veteran’s private insurance information. VA Revenue Operations coordinates directly with the insurer once your notification is on file.

How to Submit Through the Portal

The portal walks you through three steps:

Enter the veteran’s demographics and the VA authorization number.
Enter the HCPCS or CPT code to confirm the service requires precertification.
Upload the medical documentation showing why the service is medically necessary.

After a successful submission the portal returns immediate confirmation and a unique precertification ID, both on-screen and by email. There is no waiting period. Once you have the ID, you can proceed with delivering the care.¹

What to Do With the Precertification ID

You do not need to include the precertification ID on the claims you file with the VA. You do need to share it with any other providers involved in the veteran’s care, such as reference labs or imaging centers, so their services tie back to the same notification.¹

2026 Enforcement Dates

The VA is phasing in mandatory enforcement by region. Once these dates pass, claims for services that required precertification will be denied if no precertification ID was obtained before the date of service:¹

September 16, 2026 for Regions 1–3, community providers in the Optum network.
September 26, 2026 for Regions 4–5, community providers in the TriWest network.

Submitting now, before your region’s date, gets your workflow in order and avoids denials once enforcement begins.

Mistakes to Avoid

The single most common error is direction. Community providers notify the VA. They do not contact the veteran’s private insurer, and they may not bill that insurer directly for VA-authorized care. The VA handles all third-party billing itself.¹

The next most common is misuse of the portal. Precertification is a notification about services already covered by an existing referral. It is not a way to request new services, extend care, or add services outside the referral’s scope. Those requests belong in the Request for Service process.¹

Finally, watch the code check. The SEOC list is useful for planning, but the portal’s response to the specific HCPCS or CPT code is the authoritative answer on whether precertification is required for a given service.

A Note for Veterans

If you are the veteran receiving community care, there is nothing for you to submit. Precertification is handled entirely between your community provider and the VA. You also do not need to sign an assignment of benefits or complete a coordination of benefits form for your private insurer as a condition of the VA’s claim being paid; federal regulations make the insurer’s payment obligation independent of paperwork from you.² Having private insurance does not affect your eligibility for VA care or your ability to use community providers.

1
U.S. Department of Veterans Affairs. Precertification Requirements
2
eCFR. 38 CFR 17.106 – VA Collection Rules; Third-Party Payers