The co-payments will be based on primary care visits ($15), specialty care visits ($50), and no co-payment

designations.  This three-tiered co-payment system will be effective for all services provided on an outpatient basis.

No Co-payments

1.  Publicly announced VA public health initiatives (for example, health fairs); or

2.  An outpatient visit solely consisting of preventive screening and immunization, for example:

            Influenza immunization

            Pneumonococcal immunization

            Hypertension screening

            Hepatitis C screening

            Tobacco screening

            Alcohol screening

            Hyperlipidemia screening

            Breast cancer screening

            Cervical cancer screening

            Screening for colorectal cancer be fecal occult blood testing

            Education about the risks and benefits of prostate cancer screening

In addition to the services listed, co-payments will not be charged for services such as routine diagnostic tests not

requiring the immediate presence of a physician.

Primary Care ($15 Co-payment)

A primary care outpatient visit is an episode of care furnished in a primary care clinic that provides health care services.

Each patient’s identified primary care clinician delivers services as part of a primary care team.  Patients do not need a

referral to access the primary care clinician and most of the primary care team.

Specialty Care ($50 Co-payment)

A specialty care outpatient visit is an episode of care furnished in a clinic that does not provide primary care, and is

only provided through a referral.  Some examples of specialty care provided at a specialty care clinic are surgical

consultative services, radiology services requiring the immediate presence of a physician, audio logy, optometry,

cardiology, magnetic resonance imagery (MRI), computerized axial tomography (CAT) scan, nuclear medicine studies,

and ambulatory surgery.