Peer Services

Colorado is reforming its behavioral health system. This transformation is vital to make sure every Coloradan can access the behavioral health care they need when they need it. The Department of Health Care Policy and Financing is working to expand the spectrum of behavioral health services for Health First Colorado (Colorado’s Medicaid program) members. This includes increasing access to peer services for members. These services are supportive and skill-building activities delivered by peer support professionals. 

Peer support professionals are individuals who use their lived experience to help others. Peers can work in a variety of settings and offer support in any area where a member with a diagnosis is receiving care from a Health First Colorado provider. Peers are an addition to the member’s care team. They can offer practical solutions and focused problem solving to help members practice building skills needed to maintain their health and wellbeing.

HCPF, in partnership with the Behavioral Health Administration (BHA), created a new provider type, Recovery Support Services Organization (RSSO), to allow for an additional path to bill for recovery-oriented Peer support services. 

In response to budget adjustments authorized by the state legislature, effective July 1, 2025, HCPF is limiting the codes that can be billed for individual contributions by Peer Support Professionals. For detailed information, please visit the Updated Peer Support Policy webpage.

Effective January 1, 2026, all Peer Support Professionals delivering Medicaid behavioral health services must either be credentialed or will be credentialed by a nationally recognized organization by July 1, 2026 to be eligible for reimbursement for delivering peer support services. Agencies must sign and submit an attestation to their RAE(s) by January 1, 2026 indicating that the Peer Support Professional is either credentialed or is in the process and will be credentialed by July 1, 2026.

Frequently Asked Questions

• Are Peer Support services billable?
• How are Peer Services reimbursed by Medicaid?
• Is transportation a reimbursable activity?
• Where can I find more information and updates about reimbursement for Peer Support services?
• Do Peers delivering Medicaid billable services need to have a certification?
• What are the requirements regarding supervision of Peer Support Professionals?
• Does my agency need to obtain a license from the BHA?
• How does my agency become a Recovery Support Services Organization (RSSO provider type 89/889) and bill Health First Colorado for services?
• Is it permitted to use a self-reported diagnosis from the client or a diagnosis reported by another provider?
• Who do I contact for help with billing and coding questions?

Are Peer services billable?

• Effective July 1, 2025, HCPF limited the codes that can be billed for individual contributions by Peer Support Professionals to the following:
  • H0038: Self-help/Peer Services
  • H0023: Behavioral Health Outreach Service
• Peer Support Professionals may deliver services within their scope as part of a multidisciplinary team for individuals with behavioral health needs. As part of a multidisciplinary team, Peers may participate in the delivery of team-based services.  For a comprehensive list of codes Peers can deliver as part of a multidisciplinary team, please refer the Updated Peer Support Policy webpage.

How are Peer Services reimbursed by Medicaid?

Peer Support services are reimbursed through the Capitated Behavioral Health Benefit as outpatient behavioral health services. HCPF provides a set amount to Managed Care Entities to cover provision of all behavioral health services provided under the Capitation. MCEs are responsible to determine, based on member needs in the region, how best to spend the money, considering factors such as number of members using particular services and number of providers available. As part of contracting, MCEs negotiate rates with each provider.  Providers negotiate and set contracts with the RAE(s) and then are able to bill Medicaid for Peer Support services.

Is transportation a reimbursable activity?

Code H0038 does cover transportation of professionals serving Health First Colorado members in circumstances where the care provider is traveling with the member in context of a skill building or coping skill building task. As an example, riding with a member on a bus line to help them learn a transit system or become comfortable with using the bus to get groceries would be a covered service. In these cases, the time spent in travel is part of the skill building activity and would be counted as part of the visit.

Where can I find more information and updates about reimbursement for Peer Support services?

Visit HCPF’s Behavioral Health Policies, Standards, and Billing References webpage and navigate to the Updated Peer Support Policy webpage to learn more.

Do Peers delivering Medicaid billable services need to have a certification?

Currently, Medicaid follows BHA rule regarding training and certification requirements for Peer Support Professionals.  

Effective January 1, 2026, all Peer Support Professionals delivering Medicaid behavioral health services must either be credentialed or will be credentialed by a nationally recognized organization by July 1, 2026 to be eligible for reimbursement for delivering peer support services. Agencies must sign and submit an attestation to their RAE(s) by January 1, 2026 indicating that the Peer Support Professional is either credentialed or is in the process and will be credentialed by July 1, 2026.

What are the requirements regarding supervision of Peer Support Professionals?

All unlicensed professionals delivering Medicaid billable services are required to be supervised by a licensed clinician serving as the Rendering Provider.  For more information, visit HCPF’s Supervision Policy for Medicaid Billable Behavioral Health Services.

• “Rendering Provider” Supervisor: The licensed clinician who is responsible for ensuring that the services being delivered are clinically indicated. They review the treatment plan goals and progress of the member receiving services, identify any new setbacks, and provide clinical oversight of the Peer Support Professional (who is an unlicensed professional) delivering the services. Any unlicensed professional that delivers Medicaid billable services must receive supervision by the licensed individual whose name appears on the claim as the rendering provider. HCPF’s Supervision Policy for Medicaid Billable Behavioral Health Services policy can be found on the Behavioral Health Policies, Standards, and Billing Reference webpage.
• Employment Supervisor: Agencies can choose to have more than one supervisor depending on the needs of the professional. One option is an Employment Supervisor. An Employment Supervisor is responsible for hiring, training, corrective actions, mentorship and day to day supervisory functions. This supervisor is responsible for setting employee goals and reviews, giving job feedback, completing all HR-related tasks, as well as holding regular check-ins, evaluating work load, problem-solving strategies and providing moral support. The Employment Supervisor does not need to have a clinical license and can provide employment supervision to Peer Support Professionals.

Does my agency need to obtain a license from the BHA?

Recovery Support Service Organizations (RSSO), agencies who employ 9 or more licensed clinicians, and agencies who deliver SUD services are required to obtain a Behavioral Health Entity (BHE) license through the BHA. Please visit the BHA’s Behavioral Health Designation and Licensing page to find more information on what is required.

How does my agency become a Recovery Support Services Organization (RSSO provider type 89/889) and bill Health First Colorado for services?

• Outreach the RAE(s) your agency is interested in contracting with to determine if there are network needs for the type of services you provide.
• Obtain appropriate licensure for the services you provide. Colorado Behavioral Health services are regulated by BHA, though certain specialized services may require other regulatory licenses.
• Enroll with HCPF.
• Contract with a Managed Care Entity (either a Regional Accountable Entity or a Managed Care Organization) for behavioral health services outlined in the State Behavioral Health Billing Manual.

Is it permitted to use a self-reported diagnosis from the client or a diagnosis reported by another provider?

Yes, when newly engaging a client in Peer Services, agencies may obtain a member’s diagnosis from another provider through a Release of Information (ROI), if applicable. If the member does not yet have an official diagnosis, it is permissible to use ‘deferred diagnosis’ on the claim form.
 

Who do I contact for help with billing and coding questions?

Please reach out to your Managed Care Entity (MCE- RAE or MSO) or you can contact the Department for questions about the billing manual at hcpf_bhcoding@state.co.us

Peer Resources

• State Behavioral Health Services Billing Manual
• Behavioral Health Policies, Standards, and Billing References
• Provider Enrollment Page
• Find Your Provider Type Page
• Provider Portal
• Provider Contacts
• Investing in the Peer Support Workforce (2023)

Stay Informed

To ask a question or make a suggestion contact us by email: hcpf_peerservices@state.co.us