Improve Medicare coverage of peer support specialists

Parity, Coverage, & Equitable Access
Diverse Workforce
social determinants of health
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People with Intellectual & Developmental Disabilities (IDD)
People with Physical Disabilities
Older Adults
Rural Communities
Coverage & Standards
Covered Benefits
Federal department
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house committees
House Ways and Means Committee
House Energy and Commerce Committee
senate committees
Senate Finance Committee


Congress should improve Medicare coverage of peer support specialists by allowing them to bill in a variety of settings where they are most often employed.


Peer support specialists are formally trained providers who offer peer support, using their lived experience with a mental health or substance use disorder (MH/SUD) to promote recovery in other individuals. Peer support specialists are cost-effective and provide critical support that helps individuals build stronger support systems, engage with treatment, and manage both MH//SUD and physical health conditions. Increasing utilization of peer support specialists (including through telehealth) is a critical way to alleviate shortages of MH/SUD professionals, particularly in rural and other underserved areas. More than half of U.S. counties lack any MH/SUD professionals. By helping individuals get the support and care they need, peer support specialists help prevent costly negative outcomes, including disability, hospitalization, incarceration, and even homelessness.[1] Indeed, research has shown that peer support services were associated with 2.9 fewer hospital admissions each year, and Medicaid programs saved an average of over $2,000 per month.[2]

While the Veterans Administration and a majority of state Medicaid programs have recognized the value of peer support specialists and cover these services, Medicare lags behind.[3] This is particularly problematic given that older adults are the least likely to receive needed mental health services; only 80 percent of older adults needing care receive it.[1] Congress took initial steps in 2022 when it passed legislation allowing Medicare billing of peer support services as part of mobile crisis interventions and integrated care.[4] However, many settings are still not allowed to bill peer support services, including important settings such as Community Mental Health Centers, Rural Health Centers, Federally Qualified Health Centers, and Community-Based Organizations. Congress should pass legislation ensuring full coverage of peer support services in Medicare.


1. Mental Health America. 2023 Issue Brief: Peer Support Services. Last Accessed September 5, 2023.

2. Bouchery, Ellen E., Michael Barna, Elizabeth Babalola, Daniel Friend, Jonathan D. Brown, Crystal Blyler, and Henry T. Ireys. 2018. “The Effectiveness of a Peer-Staffed Crisis Respite Program as an Alternative to Hospitalization.” Psychiatric Services. Last Updated October 1, 2018.

3. Kaiser Family Foundation. Medicaid Behavioral Health Services: Peer Support Services. (n.d.)

4. Consolidated Appropriations Act, 2023. Public Law No: 117-328 (Connolly-Hice), 117th Congress (2021-2022). Last Accessed August 14, 2023.