Medicaid Reimbursement for Peer Support Services: A Detailed Analysis of Rates, Processes, and Procedures

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As part of the PR CoE’s supplemental funding provided in 2023 to increase the number of Recovery Community Organizations able to bill insurance and be reimbursed for peer recovery support services, this report was developed to provide a state-by-state analysis of Medicaid reimbursement specifically for peer support services, including peer recovery support services for substance use disorders and mental health peer support services.

This report provides a national overview of:

Which states offer Medicaid reimbursement specifically for peer support services
Reimbursement rates for one-on-one and group peer support services
Funding authority types and selections by each state
Billing codes and modifiers used by each state to specify peer support services
Recommendations

Funding for this initiative was made possible by grant no. 1H79TI083022 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.