VA Behavioral Health Referrals: 600K Community Care Referrals, $4.29B Spending, FY2021-2024
Summary
GAO report GAO-26-108799 examines VA behavioral health referrals to community providers for fiscal years 2021 through 2024. Veterans received over 600,000 referrals, with more than half for outpatient psychotherapy. VA spent $4.29 billion on community care through these referrals, with over two-thirds of spending on inpatient care including residential treatment. About 4 percent of referrals (over 25,000) and 43 percent of spending ($1.9 billion) were for residential substance use treatment.
What changed
GAO published report GAO-26-108799 providing data on VA behavioral health referrals to community providers during fiscal years 2021 through 2024. The report found veterans received over 600,000 referrals, with over half for outpatient psychotherapy, and VA spent $4.29 billion total, with over two-thirds on inpatient care. Residential substance use treatment accounted for about 4 percent of referrals but 43 percent of spending ($1.9 billion).
The report is informational and does not impose new compliance obligations. Healthcare providers participating in VA's Veterans Community Care Program and government agencies overseeing veteran healthcare may use this data to assess program spending and referral volumes. The findings on residential treatment costs relative to referral volume may inform future program planning and resource allocation.
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Archived snapshot
Apr 14, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
GAO-26-108799 Published: Apr 14, 2026. Publicly Released: Apr 14, 2026.
Fast Facts
The Department of Veterans Affairs can refer eligible veterans to health care providers outside of its medical facilities. VA has increasingly done so for veterans seeking behavioral health care, including for mental health or substance use conditions.
Veterans received over 600,000 referrals for behavioral health care from 2021 through 2024. More than half of these referrals were for outpatient therapy.
This Q&A report provides information on the referrals veterans received, including the care for which they were referred, and how much VA spent on that care.
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Highlights
What GAO Found
The Department of Veterans Affairs (VA) operates the nation’s largest health care system through its Veterans Health Administration (VHA) and serves about 9 million veterans annually. VA’s Veterans Community Care Program allows eligible veterans to receive care from private sector community providers in certain circumstances. For example, veterans who face long wait times or other challenges accessing behavioral health services for mental health or substance use conditions at VHA facilities may receive them from community providers.
GAO found that veterans received over 600,000 referrals to obtain behavioral health services from community providers during fiscal years 2021 through 2024. Over half of these referrals were for outpatient psychotherapy care. VA data show the agency spent $4.29 billion on the community care veterans obtained through these referrals as of the time of this review, and over two-thirds of VA’s spending was associated with inpatient care, including residential treatment. Inpatient care is generally more expensive than outpatient care due to costs associated with overnight stays in a facility.
Veterans’ Behavioral Health Care Referrals to Community Providers and Associated VA Spending by Care Category, Fiscal Years 2021–2024
Specifically, GAO found that about 4 percent of behavioral health referrals (over 25,000 referrals) and 43 percent of spending (about $1.9 billion) were associated with residential substance use treatment in the community during these fiscal years. Residential treatment programs for substance use disorders allow veterans to receive intensive treatment in a supervised residential setting.
Why GAO Did This Study
GAO was asked to report on veterans’ behavioral health referrals to community care during fiscal years 2021 through 2024. This report provides information on the number of referrals veterans received during this period, the care veterans received through those referrals, and VA’s spending on that care (i.e., the total cost associated with these referrals).
GAO analyzed VA data and documentation on behavioral health referrals that veterans received in fiscal years 2021 through 2024 for which VA has received a claim from the community care provider as of January 2026. Each referral includes one category of care (e.g., outpatient individual psychotherapy) that indicates the specific services (e.g., counseling and therapy sessions) that the community provider is authorized to provide over a set duration of time (e.g., 6 or 12 months). GAO also interviewed VA officials knowledgeable about these data.
For more information, contact Sharon M. Silas at SilasS@gao.gov.
Full Report
GAO Contacts
Sharon M. Silas Director Health Care silass@gao.gov
Media Inquiries
Sarah Kaczmarek Managing Director Office of Public Affairs media@gao.gov
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Topics
Veterans Veterans Health care Health care services Veterans affairs Inpatient care Veterans health care Mental health Diseases Therapy Health care standards
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