Certified Peer Specialist Services

Revised: May 29, 2025

· Overview

· Eligible Providers

· Eligible Members

· Authorization Requirements

· Billing

· Legal References

Overview

Certified Peer Specialist Services are specific rehabilitative services emphasizing the acquisition, development and enhancement of skills needed by an individual with a mental illness to move forward in their recovery. These services are self-directed and person-centered with a focus on recovery. Certified Peer Specialist Services are identified in an individualized treatment plan and are characterized by a partnering approach between the certified peer specialist and the person who receives the services.

Eligible Providers

Level I and Level II certified peer specialists are not eligible to enroll with MHCP. They are employed in agencies approved to provide peer services within the following mental health rehabilitation services:

· Assertive Community Treatment (ACT)

· Intensive Residential Rehabilitative Services (IRTS)

· Adult Rehabilitative Mental Health Services (ARMHS)

· Crisis Response Services

· Certified Community Behavioral Health Centers (CCBHC)

Level I certified peer specialists must meet the following criteria:

· Have or have had a diagnosis of mental illness

· Is a current or former recipient of mental health services

· Successfully completes the Minnesota Department of Human Services (DHS) approved Certified Peer Specialist training and certification exam

Level II certified peer specialists must meet all requirements of a Level I certified peer specialist and be qualified as a mental health practitioner.

Scope

Certified peer specialists under treatment supervision of a mental health professional or certified rehabilitation specialists must:

· Provide individualized peer support to the member

· Promote the member’s recovery goals, self-sufficiency, self-advocacy, and development of natural supports

· Support the member’s maintenance of skills learned from other services.

Eligible Members

Members must meet all of the following to receive peer services:

· Be aged 18 or older

· Receive ACT, ARMHS, IRTS, Adult Crisis services or be enrolled in a CCBHC

Authorization Requirements

Authorization is required for more than 300 hours per calendar year combined total of H0038, H0038-U5 and H0038-HQ. Refer to Authorization for general authorization policy and procedures.

Billing

Entities eligible to bill for certified peer specialists as separate service are:

· ARMHS providers

· Adult crisis service providers (mobile and residential)

Certified Peer Specialist Services provided within an ACT team, CCBHC or IRTS facilities are included in the daily rate. Do not bill separately for these services.

Certified Peer Specialist Services (CPSS) Benefits
Code	Mod	Brief Description	Units	Service Limitations
H0038		Self-help/Peer Services by Level I Certified Peer Specialist	15 min.	Authorization is required for more than 300 hours per calendar year combined total of H0038, H0038 U5, and H0038 HQ
	U5	Self-help/Peer Services by Level II Certified Peer Specialist
	HQ	Self-help/Peer Services in a group setting

Legal References

Minnesota Statutes, 256B.0615 Mental Health Certified Peer Specialist
Minnesota Statutes, 245I.04
Minnesota Statutes, 245I.06 Treatment Supervision