Act would allow reimbursement of peer support services
Washington, D.C. – Mental Health America (MHA), the National Association of Peer Supporters (NAPS), the National Association of State Mental Health Program Directors (NASMHPD), the Depression and Bipolar Support Alliance (DBSA), the Association for Behavioral Health and Wellness (ABHW), and the National Council for Mental Wellbeing (NCMW) issued the following statement today:
“We are pleased to see the introduction in Congress of the Peers in Medicare Act, bipartisan legislation to provide for Medicare coverage of peer support services when delivered by community health centers and other peer services providers.
Sen. Catherine Cortez Masto (D-NV), Sen. Bill Cassidy (R-LA), Congresswoman Judy Chu (D-CA), and Congressman Adrian Smith (R-NE) are again paving a way for individuals with mental health conditions and substance use disorders to access a full continuum of services that are person-centered and recovery oriented. This bill builds on top of their work in the 117th Congress recognizing peer support specialists in Medicare as part of interdisciplinary integrated care teams and mobile crisis teams. It does so by expanding the ability to provide peer support services in community mental health centers, federally qualified health centers, rural health clinics, and certified community behavioral health clinics.
Peer support specialists use their lived experience with a mental health condition and/or substance use disorder along with specialized training to complement and enhance another individual’s recovery through the delivery of peer support services. Peer support services help reduce hospitalizations and behavioral crises, improve management of co-occurring physical conditions, help restore relationships and social connection, and ultimately saves lives.
The Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes peer support as an effective, evidence-based practice and most recently released national model standards for certification of peer support specialists. The Veterans Health Administration has offered peer support services and continues to expand the number of peer support specialists it hires because of their ability to help veterans stay healthy. Additionally, the Centers for Medicare & Medicaid Services recently issued three guidance documents strongly encouraging adoption of peer support services, building on top of guidance from 2007 and 2019 recognizing peer support services as a reimbursable service in Medicaid and Medicare Advantage, respectively. The new guidance explains uses and requirements for the newly created Principle Illness Navigation code for peer support in integrated care Medicare settings and provides clarity around supervision and reimbursement of both adult and youth peer services in state Medicaid programs.
As our nation responds to the growing mental and substance use needs, MHA, NAPS, NASMHPD, DBSA, ABHW, and NCMW strongly support this measure providing Medicare coverage for peer support services, and we urge swift passage of this important legislation.”
Additional information
- Senate bill sponsors press statement
- House of Representatives bill sponsors press statement
- Bill text (PDF)
- Watch the Congressional briefing on peer support
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About Mental Health America
Mental Health America is the nation’s leading community-driven nonprofit dedicated to promoting mental health and well-being, resilience, recovery, and closing the mental health equity gap. Mental Health America’s work is driven by its commitment to promote mental health as a critical part of whole-person health, including prevention services for all; early identification and intervention for those at risk; and integrated care, services and supports for those who need them. Learn more at MHAnational.org.