Medicaid Behavioral Health Services: Peer Support Services

2022

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 40; No - 5; NR - 6	Yes - 3	Yes - 16
Alabama	Yes	Yes - not specified	No
Alaska	Yes	No	100 hour limit for any combination of individual services; 180 limit for group services
Arizona	Yes	NR	No
Arkansas	NR	NR	NR
California	Yes	No	No
Colorado	Yes	No	No
Connecticut	No
Delaware	NR	NR	NR
District of Columbia	Yes	No	Yes - not specified
Florida	Yes	No	Limit of 1 unit per day for 365/366 days per state fiscal year
Georgia	NR	NR	NR
Hawaii	Yes	No	No
Idaho	Yes	No	No
Illinois	No
Indiana	Yes	No	NR
Iowa	Yes	No	No
Kansas	Yes	No	No
Kentucky	Yes	No	NR
Louisiana	Yes	No	NR
Maine	No
Maryland	Yes	No	Yes - not specified
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	NR	NR	NR
Mississippi	Yes	No	For community mental health centers only, limit of 6 per day; 15 minutes unit; 200 per state fiscal year
Missouri	Yes	No	No
Montana	Yes	No	Yes - not specified
Nebraska	Yes	No	No
Nevada	Yes	No	Prior authorization is required; limits vary by level of care
New Hampshire	NR	NR	NR
New Jersey	Yes	No	No
New Mexico	Yes	No	No
New York	Yes	No	No
North Carolina	Yes	No	Limit of 24 unmanaged visits once per espisode of care per state fiscal year; prior authorization is required for up to 270 units of service per 90 days - additional units may be authorized if clinically appropriate
North Dakota	Yes	No	Only covered for individuals eligible for 1915(i)
Ohio	Yes	No	Covered for individuals enrolled in 1915(i) Specialized Recovery Services Program, and for Substance Use Disorder
Oklahoma	Yes	$3	No
Oregon	Yes	No	Limit of 96 units, with a 15 minute unit max
Pennsylvania	Yes	$.65 per unit of service	No
Rhode Island	Yes	No	No
South Carolina	Yes	No	Limit of 16 15-minute units per day; only provided by SC Department of Mental Health and Department of Alcohol and Other Drug Abuse Services
South Dakota	No
Tennessee	Yes	No	No
Texas	Yes	No	Limit of 104 units in a rolling 6 month period; the limit may be exceeded with documentation of medical necessity for the additional services
Utah	NR	NR	NR
Vermont	No
Virginia	Yes	No	Registration is required
Washington	Yes	No	No
West Virginia	Yes	No	Based on medical necessity
Wisconsin	Yes	No	Limited to programs that include peer supports in the State Plan (psychosocial rehab, residential SUD treatment, SUD health home)
Wyoming	Yes	No	No

2018

Location	Service Covered?	Copayment Required?	Limits on Services?
United States	Yes - 32 No - 14 NR - 5	Yes - 2	Yes - 11
Alabama	No
Alaska	Yes	No	No
Arizona	Yes	No	No
Arkansas	Yes	NR	NR
California	No
Colorado	Yes	No	No
Connecticut	No
Delaware	No
District of Columbia	No
Florida	Yes	$2.00 copayment per visit	Certified peer specialists can provide psychosocial rehabilitation services.
Georgia	Yes	No	No
Hawaii	Yes	No	No
Idaho	Yes	NR	NR
Illinois	NR	NR	NR
Indiana	Yes	No	Medicaid Rehab Option package of services required
Iowa	NR	NR	NR
Kansas	Yes	No	No
Kentucky	Yes	Co Pay $3	No
Louisiana	No
Maine	No
Maryland	No
Massachusetts	Yes	No	No
Michigan	Yes	No	No
Minnesota	Yes	No	NR
Mississippi	Yes	No	Limited to 6 Daily, Maximum of 200 Yearly.
Missouri	Yes	No	No
Montana	No
Nebraska	Yes	No	Peer Support is provided in conjunction with one or more Medicaid reimbursable behavioral health services
Nevada	Yes	No	PA required. LOC 1 & 2, max 6 hrs per 90-day period; LOC 3, max 9 hrs per 90-day period; LOC 4-6, max 12 hrs per 90-day period.
New Hampshire	NR	NR	NR
New Jersey	No
New Mexico	Yes	No	No
New York	NR	NR	NR
North Carolina	Yes	No	• Initial authorization – First 90 days (or when a person is experiencing a period of instability): no more than 20 hours per week individual and/or group. • Step down to sustaining support – After first 90 days and up to subsequent 90-days no more than 15 hours per week except when necessary to address short-term problems/issues. • Intermittent support – After 180 days, no more than 10 hours per week of individual and/or group.
North Dakota	No
Ohio	Yes	No	Cannot exceed 4 hours per day
Oklahoma	Yes	No	NR
Oregon	Yes	No	No
Pennsylvania	Yes	No	Medical necessity
Rhode Island	Yes	No	No
South Carolina	NR	NR	NR
South Dakota	No
Tennessee	Yes	No	No
Texas	No
Utah	Yes	No	No
Vermont	No
Virginia	Yes	No	No
Washington	Yes	No	Some require prior authorization
West Virginia	Yes	No	No
Wisconsin	Yes	No	Covered under psychosocial rehabilitation model.
Wyoming	Yes	No	Peer support services are only provided by state certified Community Mental Health Clinics or Substance Abuse Treatment Clinics. Prior authorization is required after the first 20 visits to confirm ongoing medical necessity

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Medicaid Behavioral Health Services: Peer Support Services

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Medicaid Behavioral Health Services: Peer Support Services

2022

2018

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