How to Become a VA Community Care Provider: Home Care Agency Guide (2026)
Who VA buys home care from, how to join your region's network, what credentialing asks for, and how homemaker and aide claims get paid.
Key Takeaways
- VA buys homemaker/home health aide, respite and skilled home health from licensed community agencies.
- Most agencies join through the Community Care Network (CCN): Optum runs Regions 1 to 3, TriWest runs Regions 4 and 5.
- Non-medical agencies need only meet state and local law to be credentialed under TriWest's current rules.
- Every visit needs a VA referral; claims go on a CMS-1500 within 180 days of service.
- VA's next network contracts require EVV for in-home personal care, so plan for it now.
Informational only. VA network rules and rates change; confirm requirements with your region's administrator before you apply.
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Regions from VA's Community Care Network page, updated July 6, 2026. VA's next network contracts, awarded in August 2026, are set to replace these five regions with two.
Can a home care agency become a VA Community Care provider?
Yes: VA purchases in-home aide, respite and skilled home health services from licensed community agencies that hold a VA network agreement.
Homemaker/Home Health Aide (H/HHA)
Help with bathing, dressing, meals and housework, from aides an RN supervises.
In-home respite
A paid aide at home so a family caregiver can take a break.
Skilled home health
Nursing and therapy at home from a Medicare-certified home health agency.
Home Based Primary Care
Delivered by VA's own staff teams, so VA does not buy it from agencies.
VA describes homemaker and home health aide care as help from a trained aide who works for an organization with a VA contract and is supervised by a registered nurse. All enrolled veterans are eligible if they meet the clinical need and the service is available locally, per VA's program page.
Veteran-Directed Care is a separate door
In Veteran-Directed Care the veteran gets a budget and hires workers directly, through aging and disability network agencies rather than home care agencies.
Should you join the Community Care Network or sign a Veterans Care Agreement?
Join the Community Care Network first, because a Veterans Care Agreement is only used when the network cannot provide the care.
| Community Care Network (CCN) | Veterans Care Agreement (VCA) | |
|---|---|---|
| Who you sign with | Your region's administrator (Optum or TriWest) | A local VA medical center |
| When VA uses it | The default path for community care | Only when the network can't provide the care |
| Who credentials you | The administrator | VA's contracted verification organization |
| Where claims go | Optum or TriWest | VA directly, payer ID 12115 |
| Rates | Network contract rate | Capped at the Medicare rate where one exists |
VCA rules are in 38 CFR 17.4110 (certification) and 38 CFR 17.4120 (rates). VA aims to decide on certification within 120 days, and an agreement runs up to three years.
How do you join the VA Community Care Network?
Contact your region's administrator, complete its contract request and credentialing, then set up referral and claim access before your first veteran.
- 1
Confirm your license
Hold whatever home care or home health license your state requires for the services you will provide. VA does not waive state licensing.
- 2
Gather your identifiers
Have your tax ID, agency NPI, proof of liability insurance at your state's required amount, and your background check process ready.
- 3
Find your region
Optum runs Regions 1 to 3 in the East, Midwest and South. TriWest runs Region 4 (the West) and Region 5 (Alaska).
- 4
Request a contract
Optum providers start at vacommunitycare.com; TriWest providers use the network request form.
- 5
Complete credentialing and sign
You become a network provider once credentialing is done and you are notified that your contract is executed.
- 6
Set up referrals and claims
Get access to VA's HealthShare Referral Manager and an electronic claims route to your administrator before the first referral arrives.
Introduce yourself locally too
Referrals come from VA medical center community care staff, so meet your nearest center's community care office once you are in the network.
What does VA credentialing require from a home care agency?
Non-medical agencies mostly prove state compliance, while skilled home health agencies also need Medicare certification and accreditation.
| Agency type | TriWest CCN credentialing requirement |
|---|---|
| Home health agency (unskilled) | Meet the requirements of state and local laws |
| Home health agency (skilled) | State law, Medicare certified or participating, Joint Commission accreditation |
| Every provider | Not on the CMS exclusion list; full, current, unrestricted licenses |
TriWest's credentialing guide also lists a tax ID, work history, criminal background disclosure, references, liability insurance at your state's required amount and an OIG-style compliance program. Licensing, NPI and education documents are marked excluded for unskilled home health.
That guide is dated July 2020
It is the administrator's current published guide, but confirm requirements with your administrator when you apply, since the network contracts are being replaced.
How do VA referrals and authorized hours work?
VA alone authorizes home care, and you deliver only the hours the VA physician ordered, even when the episode allows more.
TriWest's unskilled home health guide explains that VA picks a Standard Episode of Care of 30, 90, 180 or 365 days. Its example: an episode allows 20 hours a week but the physician ordered 10, so the agency provides 10.
Need more hours?
Ask VA for a new episode of care. Units beyond the authorization are not paid.
Think a veteran needs care?
Submit a Request for Services. VA typically has up to 14 days to review it.
Hospital discharge?
The ordering physician or facility must send an urgent request before discharge. Confirm it was sent.
Not credentialed yet?
The administrator cannot issue you a referral, so finish credentialing before marketing to VA.
How do VA home care claims get billed and paid?
Bill each authorized visit on a CMS-1500 to your administrator within 180 days, priced by the VA Fee Schedule for the visit's zip code.
| Code | What it bills | Unit |
|---|---|---|
| G0156 | Home health aide services | 15 minutes |
| G0162 | RN management of the plan of care | 15 minutes |
| S5120, S5125, S5130, S9122 | Other codes TriWest says referrals typically allow | Per the referral |
- 1
One claim per date
Put every charge for the same date on one claim, with modifier 76 and a time-of-day modifier (UF morning, UG afternoon, UH evening, UJ night).
- 2
Include the referral number and Veteran ID
TriWest denies claims missing the VA referral number or with a wrong Veteran ID. Enter the ID without dashes or spaces.
- 3
File within 180 days
Federal law (38 U.S.C. 1703D) sets 180 days. VA must pay clean electronic claims within 30 days and paper claims within 45.
VA sets rates in a fixed order: a contract rate first, then Medicare, then the VA Fee Schedule, then a share of billed charges. The 2026 schedule covers services from January 1 through December 31, 2026.
Check your local rate before you staff up
Rates vary by zip code and can drop. Home Health Care News reported 2026 cuts to aide rates in parts of Texas and New Mexico.
What is changing in the VA Community Care Network?
VA is replacing today's five-region network with a next-generation network of two regions, and its draft requirements add EVV for in-home visits.
Two regions instead of five
VA's next-generation solicitation, released December 2025, splits the country into East and West.
EVV for personal care
Draft requirements call for electronic visit verification on in-home personal care and home health visits.
90-day credentialing
Draft rules require administrators to finish credentialing within 90 days of the provider's acknowledgment.
Background checks for aides
Unlicensed, unskilled staff get a background check in place of a license.
No switch date announced
VA has not announced when providers move to the new network. Keep your current agreement active and watch your administrator's notices.
If you already run electronic visit verification for Medicaid, you are ahead: the draft rules require the same six visit data elements under the 21st Century Cures Act. Agencies still on paper timesheets should plan the change before the new network starts.
Frequently Asked Questions
Does a non-medical home care agency need Medicare certification to join the VA Community Care Network?
Not under TriWest's published credentialing guide, which asks unskilled home health agencies only to meet state and local law. Skilled home health agencies must be Medicare certified or participating and Joint Commission accredited. Confirm current rules with your administrator when you apply.
Who do I contact to become a VA community care provider?
Your region's administrator. Optum handles Regions 1 to 3 through vacommunitycare.com, and TriWest handles Region 4 (the West) and Region 5 (Alaska) through its network request form. VA's Community Care Network page lists each region's states and phone numbers.
How long do VA home care claims take to get paid?
Federal law requires VA to pay clean electronic claims within 30 days and clean paper claims within 45 days of receipt. You must file within 180 days of the date of service, and claims without the VA referral number are denied.
Can I provide more hours than the VA physician ordered if the episode of care allows it?
No. TriWest instructs agencies to provide only the hours the VA physician ordered, even when the Standard Episode of Care authorizes more. For additional hours, ask VA for a new episode of care.
Does VA require electronic visit verification for home care?
VA's current network guides do not list an EVV requirement. The draft requirements for VA's next-generation network do require EVV for in-home personal care and home health visits, using the same six data elements as Medicaid EVV.
Sources
- 1.VA: Community Care Network regions and administrators (accessed October 29, 2026)
- 2.VA: Homemaker and Home Health Aide Care (accessed October 29, 2026)
- 3.VA: Veteran-Directed Care (accessed October 29, 2026)
- 4.VA: Community care provider claims (accessed October 29, 2026)
- 5.VA: VA Fee Schedules (accessed October 29, 2026)
- 6.TriWest: CCN Unskilled Home Health Care Quick Reference Guide (rev. September 26, 2025) (accessed October 29, 2026)
- 7.TriWest: CCN Provider Credentialing Requirements (July 15, 2020) (accessed October 29, 2026)
- 8.38 U.S.C. 1703D: Prompt payment standard (accessed October 29, 2026)
- 9.38 CFR 17.4110: Veterans Care Agreement certification (accessed October 29, 2026)
- 10.38 CFR 17.4120: Veterans Care Agreement payment rates (accessed October 29, 2026)
- 11.VA CCN Next Gen Medical Performance Work Statement, East (draft, April 9, 2026) (accessed October 29, 2026)
- 12.Home Health Care News: VA's 2026 rate cuts in Texas and New Mexico (December 16, 2025) (accessed October 29, 2026)
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