Veteran/Beneficiary Claim for Reimbursement of Travel Expenses (VA Form 10-3542 and BTSSS)

Pursuant to 38 U.S.C. 111 and 38 C.F.R. Part 70, Subpart A, the Veterans Health Administration (VHA) Beneficiary Travel (BT) Program provides payments for authorized travel expenses to help Veterans and other beneficiaries obtain care or services from VHA and VA authorized non-VA providers in the community. VHA must administer payments according to statutory mandates, including the Payment Integrity Information Act of 2019 (PIIA) (Public Law 116-117). In compliance with the PIIA and other program requirements, VHA must gather certain information to determine whether BT eligibility and other criteria for approval have been met, and the amount of payment or reimbursement that is authorized under the BT program. Claimants may include Veterans and other BT beneficiaries, and entities or individuals who provided or paid for travel. Claimants may apply for BT reimbursement orally or in writing through VA Form 10-3542 or the Beneficiary Travel Self Service System (BTSSS). This standard collection of information is necessary to enable VHA to provide this benefit and appropriately ensure that funds are being paid to the correct claimant. VA Form 10-3542 has been revised to add intake fields for VHA use only. In the upper right area on page 1, two fields have been added for “Facility ID” and “Claim Received Date.” There are no changes to the estimated numbers of respondents or burden hours

The latest form for Veteran/Beneficiary Claim for Reimbursement of Travel Expenses (VA Form 10-3542 and BTSSS) expires 2027-11-30 and is listed under ICR 202505-2900-003.