Section 42. Peer Support Services

Peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders. A. Eligible practitioners: Must be self-identified consumers who are in recovery from mental illness or substance use disorder. In addition to the requirements of Subsections A and B of 8.321.2.9 NMAC, in order to be eligible to be reimbursed for providing peer support services practitioners meet the following qualifications: (1) Certified peer support workers (CPSW) must: (a) complete the certification program offered through BHSD; (b) be certified by the NM credentialing board for behavioral health professionals; (c) complete 20 hours of initial training and 20 hours of education every subsequent year; (d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and (e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals. (2) Certified family peer support workers (CFPSW) must: (a) complete the certification program offered through CYFD; (b) be certified by the NM credentialing board for behavioral health professionals; (c) complete 20 hours of initial training and 20 hours of education every subsequent year; (d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and (e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals NM credentialing board for behavioral health professionals; (c) complete 20 hours of initial training and 20 hours of education every subsequent year; (d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and (e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals. (3) Certified youth peer support specialists (CYPSS) must: (a) complete the certification program offered through CYFD; (b) be certified by the NM credentialing board for behavioral health professionals; (c) complete 20 hours of initial training and 20 hours of education every subsequent year; (d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and (e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals. B. Non-covered services: Peer support services are subject to the limitations and coverage restrictions that exist for other MAD covered services. See Subsection G of 8.321.2.9 NMAC for general non- covered specialized behavioral health services. 8.321.2 NMAC 65 C. Reimbursement: peer support providers must submit claims for reimbursement on the CMS- 1500 claim form or its successor. See Subsection E of 8.321.2.9 NMAC for MAD general reimbursement requirements and 8.302.2 NMAC. Once enrolled, the peer support provider receives instructions on how to access documentation, billing, and claims processing information.