OMB control number

Request for Payment of Bowel and Bladder Services (VA Form 10-314)

OMB 2900-0924 · VA.

OMB 2900-0924

Legal authority for this information collection is found in 38 U.S.C., Chapter 17, for Veterans seeking health care services. Data collected may be used to establish, determine, and monitor eligibility to receive VA benefits and for authorizing and paying Non-VA healthcare services furnished to Veterans and beneficiaries. VA Form 10-314 will be required to request reimbursement for bowel and bladder care services. The form is used to list the dates and times the care was rendered to the Veteran and is then submitted monthly to VA to request payment for those services.

The latest form for Request for Payment of Bowel and Bladder Services (VA Form 10-314) expires 2026-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 10-314b VA Form 10-314b - Request for Payment of Bowel and Bladder Services Form
Form 10-314a Bowel and Bladder Services Preauthorization Form Form
Department of Veterans Affairs_VA Form 314B Comment_PO Response_Signed_02282023.pdf Supplementary Document
30-day FRN - 2900-NEW - Preauthorization & Request for Payment of Bowel & Bladder Services - published 03012023.pdf Supplementary Document
60-day FRN - 2900-NEW - Preauthorization & Request for Payment of Bowel & Bladder Services - published 12152022.pdf Supplementary Document
Supporting Statement A_Preauthorization Request for Payment of Bowel Bladder Services_10-314a 10-314b_2900-NEW_updated Feb 2023.docx Supporting Statement A
VA Form 10-314b - Request for Payment of Bowel and Bladder Services Form
Bowel and Bladder Services Preauthorization Form Form

All Historical Document Collections

202207-2900-006

Approved with change

New collection (Request for a new OMB Control Number)

2023-03-01