VA facilities do not have "in-house" obstetrical (OB) service. The VA pays for OB care through the Fee Basis program.
You pick an OB doctor and hospital or birthing center in your area. The VA pays the OB doctor a package rate, with a set number of visits, lab tests, and ultrasounds.
Fee Basis is not health insurance: the VA pays a set fee for the services you get from your OB, which is similar to Medicare rates.
Your VA provider requests Fee Basis consults for your OB care. He/she needs to know:
If you want VA to pay for your maternity care, ask your Primary Care Provider to request that through the Fee Basis office. When it is approved, you will receive the Authorization for OB services in the mail, or the Authorization can be faxed to your provider of choice – just provide us the FAX number for the OB provider you have chosen.
Important Note: Contact Fee Basis within 15 days of an ER visit or within 72 hours of an inpatient hospital admission to determine payment information.
Recent Congressional law now permits the VA to pay for "authorized medical care for the newborn child of a woman Veteran who is receiving maternity care furnished by the VA, for not more than seven consecutive days after the birth of the child..."
Check with your Fee Basis office for more details about what they need from you to pay your baby’s bills.
If you were seeing a specialist at the VA (such as mental health experts like Psychologists or Psychiatrists) before you got pregnant, you may continue to see them. Notify your providers that you are pregnant so they can properly adjust medications for the safety of the baby.
During your pregnancy, your OB provider may refer you to a non-VA specialist.
Your OB provider needs to get approval for this additional care BEFORE you can be seen.
Telephone the VA Fee Basis office for pre-approval for any specialty consultation.
Pregnant Veterans who report to any Bay Pines VAHCS facility with urgent problems, such as mental health issues, may be triaged and treated or referred to another facility. Treatment depends on your stage of pregnancy, health status, and resources on hand. We will act in the best interests of the woman Veteran and the baby.
The VA is not equipped to address OB emergencies. Discuss plans for emergencies with your OB provider.
Your VA Primary Care provider may prescribe common pills, such as prenatal vitamins.
Your OB provider should prescribe all other drugs that you need during your pregnancy. These medications should be filled through the VA Pharmacy. Or, you may fill the prescription at your local pharmacy at your own expense.
Call the Fee Basis office if you have special circumstances. You can also call the Bay Pines Pharmacy for more information at (727) 398-6661, and follow the prompts to speak with a Pharmacy technician.
If your OB provider needs copies of your medical records, go to the Release of Information Office (ROI). At Bay Pines Medical Center, ROI is in Bldg 100, Room 1E-301, telephone (727) 398-6661, ext. 4463. If you get healthcare at a CBOC, check with them about getting your records.
After the OB discharges you, remember to come back to the VA for your ongoing Primary Care. Your baby needs you to stay healthy!
Obtain a copy of all important medical notes and tests from your OB provider. Bring these with you to your next VA Primary Care appointment. Your VA provider will want to review this information to develop your medical plan of care.
Please refer any billing questions to the VA Fee Basis Office. Here are some points to remember:
VA is not an insurance plan – but we do pay a fee for the services your OB renders at standard rates. When VA issues an authorization for your care to be paid by VA, it will cover you from the time you receive it through the initial post partum weeks, until your OB provider discharges you back to your Primary Care Provider.
VA pays for “global obstetrical care.” This means the VA pays the hospital and obstetrician a standard rate based on how many visits, tests, and procedures you need.
If you need extra care above the original amount that was approved, such as more ultrasounds or ER visits, the OB doctor’s office needs to contact the Fee Basis Office BEFORE the procedure is done (if possible).
Your OB doctor may need to submit extra records that show medical need before extra visits or work can be approved.
Depending on the urgent need of the procedure, the OB office should telephone, fax, or mail the request to the VA Fee Basis Office for approval.
Your OB doctor’s office should direct their calls and bills directly to the VA Fee Basis Office if they have any questions.
Please make sure the VA has your most recent address and telephone contact information.
Bay Pines VA Fee Basis Unit,
P.O. Box 5005 (11FB)
Bay Pines, FL 33744
(727) 398-3225, or
(888) 820-0230, ext 3231
Fax: (727) 398-3260
(727) 398-6661, ext. 4312
(888) 820-0230, ext. 4312
Fax: (727) 398-9346