Standardized Episodes of Care (Bundled Services)

The U.S. Department of Veterans Affairs (VA) has implemented standardized episodes of care, also referred to as bundled services, on certain authorizations, under the Veterans Choice Program (VCP) and Patient-Centered Community Care (PCCC) program. These authorizations encompass an overall course of treatment, rather than a specific service(s).

VA recognizes certain courses of treatment can be reasonably predicted. For example, a veteran who requires joint replacement can be expected to receive physical therapy as part of his/her treatment. With bundled services, predictive treatment (outlined in the authorization) will be covered without the need for additional approval. While this is similar to what is being done today, bundled services will often have less restrictions on visit limits or other care parameters.

Provider Notification Packet

The provider notification packet will indicate ‘bundled services’ in the clinical notes when a standardized episode of care is authorized.

Additional Authorization/Inpatient Notification

Covered Services

You may click on each service to view the types of coverage included in the bundled service.

Type of Care SEOC (Version-Effective Date)
Mandatory/ Optional Program
Infertility Care IUI female (V01-12/19/2017)
optional VCP/PCCC
IUI female (V02-02/07/2018) mandatory VCP/PCCC
IUI male (V01-12/19/2017)
optional
VCP/PCCC
IUI male (V02-02/07/2018)
IUI male (V03-03/22/2018)
mandatory VCP/PCCC
ART/IVF female (V01-12/19/2017)
optional PCCC Only
ART/IVF female (V02-02/07/2018)
ART/IVR female (V03-03/22/2018)
mandatory PCCC Only
ART/IVF male (V01-12/19/2017)
optional PCCC Only
ART/IVF male (V02-02/07/2018)
ART/IVF male (V03-03/22/2018)
mandatory PCCC Only
Lab and Pathology Services anti-coag lab (V01-02/07/2018)
anti-coag lab (V02-03/22/2018)
optional VCP/PCCC
lab and pathology (V01-02/07/2018) optional VCP/PCCC
Medical Specialty Care allergy (immunology) (V01-02/07/2018)
optional VCP/PCCC
audiology (V01-12/19/2017)
audiology (V02-02/07/2018)
optional VCP/PCCC
cardiology (catheterization and PCI) (V01-12/19/2017)
mandatory VCP/PCCC
cardiology (comprehensive) (V01-12/19/2017)
cardiology (comprehensive) (V02-02/06/2018)
cardiology (comprehensive) (V03-03/22/218)
optional VCP/PCCC
cardiology (TAVR) (V01-12/19/2017)
mandatory VCP/PCCC
chemotherapy (outpatient) (V01-02/07/2018) optional VCP/PCCC
chronic pain management (injections) (V01-05/18/2017)
chronic pain management (injections) V02-02/07/2018)
optional VCP/PCCC
chronic pain management (spinal cord stimulator) (V01-05/18/2017)
chronic pain management (spinal cord stimulator) (V02-02/07/2018)
optional VCP/PCCC
colonoscopy (screening) (V01-12/19/2017)
optional VCP/PCCC
dermatology (skin illnesses, disorders, biopsy) (V01-12/19/2017)
dermatology (skin illnesses, disorders, biopsy) (V02-02/07/2018)
mandatory VCP/PCCC
emergency/urgent care (V01-03/22/2018) mandatory PCCC Only
GI (upper and lower routine procedures) (V01-05/18/2017)
GI (upper and lower routine procedures) (V02-02/07/2018)
optional VCP/PCCC
hematology (V01-02/07/2018) optional VCP/PCCC
hematology/radiation oncology (comprehensive) (V01-02/07/2018) optional VCP/PCCC
infectious disease (V01-02/07/2018) mandatory VCP/PCCC
oncology (comprehensive) (V01-02/07/2018)
oncology (comprehensive) (V02-03/22/2018)
optional VCP/PCCC
optometry (V01-12/19/2017)
optometry (V02-02/07/2018)
optometry (V03-03/22/2018)
mandatory VCP/PCCC
maternity (V01-05/18/2017)
maternity (V02-02/07/2018)
mandatory VCP/PCCC
neurology (V01-02/07/2018) mandatory VCP/PCCC
pulmonary (V01-12/19/2017)
pulmonary (V02-02/07/2018)
pulmonary (V03-03/22/2018)
mandatory VCP/PCCC
pulmonary bronchoscopy (V01-02/07/2018) optional VCP/PCCC
radiation therapy (V01-02/07/2018) mandatory VCP/PCCC
renal (V01-02/07/2018) optional VCP/PCCC
rheumatology (V01-02/07/2018) mandatory VCP/PCCC
sleep study (V01-05/18/2017)
sleep study (V02-02/07/2018)
optional VCP/PCCC
Mental Health Care office-based buprenorphine (6 months) (V01-05/07/2018)
optional
VCP/PCCC
office-based buprenorphine (12 months) (V01-05/07/2018)
optional
VCP/PCCC
opioid treatment program – methadone (6 months) (V01-05/07/2018)
optional
VCP/PCCC
opioid treatment program – buprenorphine (6 months) (V01-05/07/2018) optional VCP/PCCC
opioid treatment program – continuation (12 months) (V01-05/07/2018) optional VCP/PCCC
Physical Medicine & Rehabilitation

acupuncture (V01-02/07/2018)

optional VCP/PCCC
cardiac rehabilitation (V01-12/19/2017)
cardiac rehabilitation (V02-02/06/2018)
mandatory VCP/PCCC
chiropractic care (V02-02/07/2018) mandatory VCP/PCCC
occupational therapy (V02-02/07/2018) mandatory VCP/PCCC
occupational therapy – functional capacity driver evaluation (V02-02/07/2018) mandatory VCP/PCCC
physical therapy (V02-02/07/2018) mandatory VCP/PCCC
pulmonary rehabilitation (V01-12/19/2017)
pulmonary rehabilitation (V02-02/07/2018)
mandatory VCP/PCCC
Primary Care

primary care three months duration (V01-12/19/2017)

mandatory VCP/PCCC
primary care six months duration (V01-12/19/2017)
primary care six months duration (V02-02/07/2018)
mandatory VCP/PCCC
primary care one year duration (V01-12/19/2017)
primary care one year duration (V02-02/07/2018)
mandatory VCP/PCCC
 Radiology CT myelogram (V01-02/07/2018) mandatory VCP/PCCC
CT scan (V01-02/07/2018) mandatory VCP/PCCC
EBUS (V01-02/07/2018) mandatory VCP/PCCC
mammogram (V01-05/18/2017)
mammogram (V02-02/07/2018)
mandatory VCP/PCCC
MRI/MRA (V01-05/18/2017)
MRI/MRA (V02-02/07/2018)
mandatory VCP/PCCC
nuclear medicine (V01-02/07/2018) optional VCP/PCCC
PET scan (V01-02/07/2018)
PET scan (V02-03/22/2018)
optional VCP/PCCC
TVUS (V01-02/07/2018) mandatory VCP/PCCC
ultrasound (V01-02/07/2018)
ultrasound (V02-03/22/2018)
mandatory VCP/PCCC
venogram (V01-02/07/2018) optional VCP/PCCC
Rehabilitative Services

chiropractic care (V01-09/22/2017)

mandatory VCP/PCCC
occupational therapy (V01-05/18/2017) mandatory VCP/PCCC
occupational therapy – functional capacity driver evaluation (V01-05/18/2017)
mandatory VCP/PCCC
physical therapy (V01-05/18/2017)
mandatory VCP/PCCC
Surgical Specialty Care cardiology (catheterization and PCI) (V02-02/07/2018)
cardiology (catheterization and PCI) (V03-03/22/2018)
optional VCP/PCCC
cardiology (TAVR) (V02-02/07/2018) mandatory VCP/PCCC
ear, nose and throat (ENT) (V01-02/07/2018)
ear, nose and throat (ENT) (V02-03/22/2018)
mandatory VCP/PCCC
neurosurgery (V01-02/07/2018)
neurosurgery (V02-03/22/2018)
mandatory VCP/PCCC
ophthalmology (V01-05/18/2017)
ophthalmology (V02-02/07/2018)
mandatory VCP/PCCC
orthopedics (joint osteoarthritis or joint replacement) (V01-09/22/2017)
orthopedics (joint osteoarthritis or joint replacement) (V02-02/07/2018)
optional VCP/PCCC
thoracic surgery (V01-02/07/2018)
thoracic surgery (V02-03/22/2018)
optional VCP/PCCC
urology (V01-02/07/2018) mandatory VCP/PCCC
vascular surgery (V01-02/07/2018)
vascular surgery (V02-03/22/2018)
optional VCP/PCCC
wound care (V01-05/18/2017)
wound care (V02-02/07/2018)
optional VCP/PCCC

Important Note: The standardized episodes of care listed above as 'optional' will be authorized as a bundle if indicated as a bundle on the VA request.

Veterans Crisis Support

Support for your patients who are U.S. Veterans:

  • 1-800-273-8255 Press 1
  • Confidential chat at VeteransCrisisLine.net or text to 838255

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