MedicaidCoverageMedium impact
Medicaid Coverage of Peer Recovery Support Services in FQHCs
Maryland Medicaid·MD · Psychiatry, Family Medicine, Internal Medicine·Provider Transmittal
Effective date
Jun 1, 2023
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now reimburses FQHCs for peer recovery support services provided to substance use disorder patients, effective June 1, 2023. FQHCs must enroll via supplemental application, employ Certified Peer Recovery Specialists supervised by Registered Peer Supervisors (required by September 1, 2023), and bill using specific HCPCS codes H0038 and H0024 at established fee-for-service rates.
Action Required
By August 31, 2023: Billing team must prepare for September 1, 2023 supervisor compliance deadline. Before that date, if your FQHC has not already done so, submit supplemental application via ePREP (or new application if not yet Medicaid-enrolled) including: (1) FQHC Provider Type 34 addendum with peer recovery attestation, (2) copies of CPRS certifications from Maryland Addictions and Behavioral-health Professionals Certification Board, (3) Registered Peer Supervisor certification or credentials documentation, and (4) pre-employment background checks. By September 1, 2023: All peer supervisors must hold Registered Peer Supervisor certification; providers with previously approved applications using non-RPS supervisors must submit supplemental application documenting RPS compliance. Update billing system to: (1) recognize H0038 at $16.38 per 15 minutes for individual peer services and H0024 at $4.55 per 15 minutes for group services, (2) require rendering provider field populated with eligible peer supervisor, (3) restrict peer service billing only when rendered with evaluation/management or individual therapy, or bill H0038/H0024 standalone only when no concurrent clinical service. Failure to complete enrollment and supervision requirements will result in claim denials. Contact mdh.mabehavioralhealth@maryland.gov for policy questions.