How are peer support services paid for? Is peer support Medicaid reimbursable?

There is no simple answer that applies to all states. Peer support is Medicaid reimbursable in most states but the mechanism differs from state to state. Some states have funded peer support as a part of their fee-for-service Medicaid program. Others are able to reimburse under Medicaid waivers 1915(b), 1115, or 2703. Many states include peer support through Medicaid Managed Care Organizations. A few states pay for some peer support from state general revenue, which allows people who are not yet on Medicaid or are not eligible for it to receive support under certain circumstances. It is important that providers wishing to offer peer support services check with their Medicaid and state and local Behavioral Health authorities.

In a few states, some large healthcare organizations and healthcare plans are conducting pilots and small, local projects to test the provision of peer support. Providers should inquire with all agencies that provide funding for their services.

This study provides more information on the impact of Medicaid peer support on costs.

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