Veterans across the U.S. are increasingly turning to massage therapy as a safe, non-opioid pain management tool. Here’s how massage therapists can join the VA’s Whole Health mission and become approved to treat veterans.
What the VA currently allows
Here are the key points:
- The VA acknowledges massage therapy (often termed “medical massage therapy” or part of “Complementary & Integrative Health” (CIH) within the VA’s “Whole Health” model) as a service that can be covered when it is clinically indicated and authorized by the VA. Veterans Affairs+2
- Example: The VA has a “Massage” page in its Whole Health Library noting the evidence basis and stating that “therapeutic massage … is mandated to be available in all VA facilities … under circumstances” albeit with clinical judgment. Veterans Affairs+1
- The VA lists a “Clinical Determination and Indication: Medical Massage Therapy” document (CDI 00036) dated June 2025 which spells out when massage therapy is medically necessary under the VA’s benefits package: e.g., for pain conditions (back pain, fibromyalgia, headaches, joint pain, plantar fasciitis, post-operative pain, neck pain, TMJ disorder) or certain non-pain conditions (lymphedema, scar tissue) when there is expectation of benefit. Veterans Affairs
- For community (outside-VA) providers, the VA’s “Community Care – Veterans Care Agreements (VCA)” policy explains that community providers must have a signed agreement (VCA) with VA, receive authorization/referrals through the VA, submit claims to VA (not to the veteran) and must not bill the veteran or the veteran’s other insurance separately for VA-authorized care. Veterans Affairs+1
- The VA’s “Fee Schedule” or “Payer Rates & Charges” page indicates that for community providers, the VA reimburses at its own schedule (“lesser of billed charges or the VA fee schedule”) for non-Medicare-recognized services. Veterans Affairs+1
What to know
These are things massage therapists must know — if they enter the VA system they’re not treated exactly like private-insurance.
- Authorization required: A veteran must be referred/authorized by the VA or its Community Care network for massage therapy services. You cannot simply “bill the VA” like a commercial payer without going through the established network. From provider-side: you must have the VCA (Veterans Care Agreement) signed before payment liability exists. Veterans Affairs
- Clinical necessity/indication: The medical massage must meet the VA’s criteria of “medically necessary” (pain conditions, etc., as above). General wellness massage likely will not qualify for VA coverage. The CDI document states “general massage for well-being is not considered medical massage therapy.” Veterans Affairs+1
- Coverage uneven by region: Although the policy is national, availability of massage therapy as a covered service varies among VA facilities and by geography. Some veterans report obtaining it, others say local facility doesn’t offer it yet. reddit.com+1
- Reimbursement / rate issues: The VA reimbursement rate may mirror Medicare or a VA-specific fee schedule; changes have occurred (for example massage therapy reimbursement cuts flagged by the American Massage Therapy Association (AMTA) for VA CCN network providers). amtamassage.org+1
- Documentation / billing detail: As with any payer, proper documentation, authorization numbers, correct coding and billing forms matter. Some third-party billing guides for massage therapy note that for VA claims you’ll need e.g., the authorization letter, date range, the number of visits authorized, etc.
Step by Step Guide to Credentialing with the VA and billing the VA for massage therapy services
The U.S. Department of Veterans Affairs (VA) recognizes clinical massage therapy as one of the evidence-based Complementary and Integrative Health (CIH) approaches within its Whole Health System of Care. When medically indicated, massage therapy may be covered for veterans as part of their VA benefits—either at VA facilities or through community-based providers like you.
If you’re a massage therapist who wants to serve veterans, here’s how to get started.
1. Apply for Your National Provider Identifier (NPI)
Every healthcare provider who bills insurance or participates in federal programs like the VA must have a National Provider Identifier (NPI)—a unique 10-digit number issued by the Centers for Medicare & Medicaid Services (CMS).
If you don’t already have one, you can apply online at NPPES.CMS.HHS.gov. You’ll need this number to complete credentialing, submit claims, and identify yourself in the VA’s network.
Most of the registration process is straightforward. When you get to “Taxonomy,” select “22: Respiratory, Rehabilitative & Restorative Service Provider,” then scroll down to “Massage Therapist.”
2. Identify Your VA Community Care Region
Massage therapists who provide services to veterans through VA Community Care must contract within their regional Community Care Network (CCN).
The U.S. is divided into six CCN regions:
- Regions 1–3: Managed by Optum
- Regions 4–5: Managed by TriWest Healthcare Alliance
- Region 6: Pending assignment (includes U.S. territories and overseas areas)
Check which region your state belongs to on the VA’s Community Care Network map, then contact your regional administrator:
- Region 1 – Optum: 888-901-7407
- Region 2 – Optum: 844-839-6108
- Region 3 – Optum: 888-901-6613
- Region 4 – TriWest: 866-286-4174
- Region 5 – TriWest: 877-226-8749
3. Complete Credentialing with Your Regional Administrator
To begin seeing veterans, you must become an approved Community Care provider by completing the credentialing process through Optum or TriWest.
Credentialing verifies your state license, liability insurance, education and experience, and background check. It typically takes 60–90 days, so start early. Once approved, you’ll sign a Veterans Care Agreement (VCA) or provider participation contract that allows you to deliver services under VA authorization.
4. Submit Your Registration and Enrollment Paperwork
After credentialing, your regional network will send electronic paperwork to finalize your enrollment. This step ensures you are officially entered into the VA’s system for referrals, authorizations, and payment. Review all instructions carefully—some regions may request copies of your NPI, tax ID (EIN), or W-9.
5. Receive Patient Referrals and Authorizations
Once your practice is active in the VA network, you’ll begin receiving referrals for eligible veterans.
Each referral must include a written authorization specifying:
- The approved CPT code(s) (such as 97124 or 97140)
- The number of visits authorized
- The time frame for treatment
You must have this authorization before treating the veteran—services provided without it will not be reimbursed. Your CCN administrator (Optum or TriWest) will issue the authorization letter, which you’ll attach to your first claim.
6. Billing and Claims: Initial Checklist
When billing the VA for massage therapy, accuracy is essential. Include all required documents and data to prevent denials.
Initial VA Claim Checklist
- ✅ Authorization letter (all pages)
- ✅ Cover letter or claim submission form
- ✅ Date range for services
- ✅ Authorization number(s)
- ✅ Number of visits authorized
- ✅ Veteran’s demographic info (address, DOB, SSN or VA ID)
- ✅ Detailed treatment documentation and CPT codes
Submit your claim to the VA facility or third-party administrator listed in your authorization packet. The VA pays the lesser of your billed charge or the VA fee schedule, depending on your region.
7. Understand Payment and Compliance Rules
Under a Veterans Care Agreement, you are considered a community provider, not a VA employee. You agree to:
- Bill only the VA, not the veteran.
- Maintain treatment documentation for at least six years.
- Follow all privacy and recordkeeping rules (HIPAA compliant).
- Notify the VA promptly of any license or insurance changes.
For many massage therapists, VA reimbursement rates are comparable to or slightly below commercial rates—but participation can provide steady referrals, help veterans access care, and position your practice within an integrative healthcare system.
8. Get Expert Help if Needed
If you’re new to medical billing or want assistance navigating VA paperwork, consider partnering with a billing service that specializes in holistic and integrative health. Companies experienced with VA Community Care claims can help ensure your credentialing, documentation, and billing processes meet all federal requirements—helping you focus on what matters most: caring for veterans.
Final Thoughts
Serving veterans through the VA Community Care Network is both meaningful and rewarding. By following the right steps—credentialing, authorization, and compliant billing—you can become part of the VA’s Whole Health movement, offering evidence-based massage therapy that helps veterans live with less pain and more mobility.
Learn how to fill out billing forms and what codes to use – Purchase my book The Massage Insurance Billing Manual.