Maryland Peer Support Services Guide

Maryland has a well-developed peer recovery workforce spanning mental health, substance use recovery, community behavioral health, hospitals, local health departments, recovery community organizations, crisis services, justice and reentry programs, recovery residences, and other community settings.

The state’s primary professional peer credential is the Certified Peer Recovery Specialist, commonly abbreviated CPRS. The credential is administered by the Maryland Addiction and Behavioral-health Professionals Certification Board, or MABPCB, and is recognized throughout Maryland’s behavioral health system. (MD Addiction Cert Board)

Maryland’s CPRS credential is intentionally broad. It is designed for peer workers supporting people experiencing mental health, substance use, or co-occurring behavioral health challenges rather than maintaining completely separate mental health and substance use peer credentials.

The certification requirements changed significantly on September 1, 2025. Current CPRS applicants must complete 50 hours of approved training across five domains, 500 hours of supervised peer recovery service, and 30 hours of supervision by a Registered Peer Supervisor. The fifth domain, Harm Reduction, was added in 2025. (MD Addiction Cert Board)

Maryland Medicaid also reimburses certain Peer Recovery Support Services. Current reimbursement is available through specified enrolled provider types, including eligible community-based substance use disorder programs, Opioid Treatment Programs, and Federally Qualified Health Centers. Medicaid-reimbursable services must be delivered by a qualified CPRS and supervised by a Registered Peer Supervisor. (Maryland.gov Enterprise Agency Template)

Maryland Peer Support Quick Facts

What Is Peer Support?

Peer support is assistance provided by someone whose relevant lived experience informs how they support another person.

In Maryland, Peer Recovery Specialists may draw on lived experience related to:

• Mental health challenges
• Substance use disorder
• Co-occurring mental health and substance use conditions
• Recovery
• Behavioral health treatment
• Family recovery
• Criminal justice involvement when appropriately trained
• Other behavioral health systems

The Maryland CPRS credential is designed for workers who use experiential expertise to provide recovery support to people living with behavioral health conditions. The credential emphasizes advocacy, mentoring and education, recovery and wellness, ethical responsibility, and, under the updated requirements, harm reduction. (MD Addiction Cert Board)

Peer Recovery Specialists may:

• Build trust and engagement
• Share relevant lived experience
• Support recovery goals
• Promote self-advocacy
• Help people navigate behavioral health systems
• Support treatment engagement
• Connect people with resources
• Help identify natural supports
• Facilitate peer support groups
• Support goal setting
• Help build recovery skills
• Support wellness
• Provide recovery education
• Connect people with crisis services when needed
• Help individuals access community supports
• Promote culturally responsive recovery support
• Support harm reduction
• Assist with transitions
• Support development of recovery capital

Maryland’s Medicaid Peer Recovery Support Services guidance specifically identifies activities such as goal-setting and skill-building, culturally competent support, peer groups, and referrals or connections to crisis and community-based services. (Maryland.gov Enterprise Agency Template)

Peer support remains distinct from licensed clinical treatment.

A CPRS may work alongside therapists, physicians, counselors, social workers, nurses, case managers, and other professionals, but CPRS certification itself does not authorize diagnosis, psychotherapy, medication management, or other functions requiring a professional clinical license.

How Peer Support Is Organized in Maryland

Maryland’s peer workforce is centered around the CPRS credential, but the state also maintains additional peer endorsements and supervisory credentials.

Major peer workforce pathways include:

• Certified Peer Recovery Specialist
• Certified Peer Recovery Specialist – Family
• Registered Peer Supervisor
• Integrated Forensic Peer Recovery Specialist
• Peer workers pursuing CPRS certification
• Peer professionals working in Medicaid-reimbursable Peer Recovery Support Services
• Peer workers in community and grant-funded recovery programs

The CPRS is the primary credential.

The CPRS-F is an additional family specialization for people who already hold an active CPRS credential. The Registered Peer Supervisor, or RPS, is the credential used for professionals supervising Maryland Peer Recovery Specialists. (MD Addiction Cert Board)

Organizations should distinguish between:

• Being employed in a peer role
• Completing peer training
• Meeting CPRS certification requirements
• Holding active CPRS certification
• Holding an additional endorsement
• Being qualified to supervise peers
• Being qualified to deliver a Medicaid-reimbursable peer service

These are not automatically equivalent.

Certified Peer Recovery Specialists

What Is a Certified Peer Recovery Specialist?

The Certified Peer Recovery Specialist is Maryland’s primary professional peer recovery credential.

MABPCB describes the CPRS as the credential for the peer recovery workforce primarily involved in providing recovery support to people living with behavioral health disorders. (MD Addiction Cert Board)

The CPRS is an IC&RC-approved certification, which gives the Maryland credential a connection to broader reciprocal peer certification standards. (MD Addiction Cert Board)

CPRS professionals may work with people experiencing:

• Mental health challenges
• Substance use disorder
• Co-occurring conditions
• Recovery transitions
• Community reintegration
• Behavioral health crises
• Other recovery needs

Current CPRS Requirements

Current MABPCB requirements include:

• Meeting applicable residency or employment requirements
• High school diploma or GED
• Relevant lived recovery experience
• 50 hours of approved training
• Completion of an approved CORE training
• 500 hours of documented peer recovery service
• 30 hours of documented supervision from a Registered Peer Supervisor
• Required references and documentation
• Passing the applicable certification examination
• Agreement to the MABPCB Code of Conduct and ethical requirements

MABPCB currently identifies the CPRS as requiring 50 training hours, 500 service hours, 30 supervision hours, and recertification every two years. (MD Addiction Cert Board)

Maryland Residency or Employment Requirement

MABPCB currently requires applicants to live or work in Maryland at least 51 percent of the time. (MD Addiction Cert Board)

This is important for people living near Maryland’s borders or working across multiple jurisdictions.

Education Requirement

A CPRS applicant must have a high school diploma or equivalent.

Official educational records may be required as part of the certification application.

Lived Experience and Recovery

Maryland’s credential is grounded in experiential expertise.

Historically, CPRS materials have required applicants to identify as being in long-term recovery from behavioral health challenges and document sustained recovery experience.

Applicants should review the current MABPCB application carefully because eligibility language and documentation requirements can change.

CPRS Training Requirements

Maryland significantly updated CPRS training requirements effective September 1, 2025.

Before the change, CPRS certification required 46 hours across four domains.

For applications submitted after September 1, 2025, applicants must complete 50 hours across five domains. (MD Addiction Cert Board)

The domains are:

The Harm Reduction domain was added as part of the 2025 requirements. (MD Addiction Cert Board)

CORE Training

All CPRS applicants must complete at least one approved CORE training.

MABPCB identifies examples such as:

• CCAR Recovery Coach Academy
• Intentional Peer Support
• WRAP-related qualifying curricula
• Mosaic peer curriculum
• Other approved CORE curricula of at least 30 hours

(MD Addiction Cert Board)

Applicants should verify that a course is currently approved before relying on it toward certification.

Training Recency

Current MABPCB requirements state that qualifying CPRS training must have been completed within the previous ten years. (MD Addiction Cert Board)

There are also limits on the number of non-interactive online and certain in-service training hours that may be applied.

CPRS Service Hour Requirement

Maryland requires 500 documented service hours of supervised paid or volunteer peer recovery support experience.

Current MABPCB requirements specify that the 500 hours must:

• Involve peer recovery support
• Be supervised
• Occur in a clinical or community setting
• Be completed within the two years before application submission
• Be documented
• Be verifiable through employer or organization records

Service hours may be accumulated across multiple organizations. (MD Addiction Cert Board)

This allows developing peer workers to build qualifying experience through a combination of employment and volunteer positions.

CPRS Supervision Requirement

Current CPRS applicants must document 30 hours of supervision from a Registered Peer Supervisor.

The supervision requirement increased from 25 to 30 hours on September 1, 2025 when Maryland added the Harm Reduction domain. (MD Addiction Cert Board)

MABPCB currently expects CPRS applicants to receive documented supervision at least twice per month. (MD Addiction Cert Board)

Supervision documentation is a central part of the certification application.

Organizations employing people who are still accumulating CPRS hours should therefore establish supervision processes before the worker approaches the certification deadline.

Registered Peer Supervisors

What Is a Registered Peer Supervisor?

A Registered Peer Supervisor, or RPS, is a Maryland credential for professionals supervising Peer Recovery Specialists.

MABPCB describes the RPS as the title for the peer recovery specialist’s supervisor. The supervisor may or may not have personal lived experience but must understand peer recovery responsibilities and effective supervision. (MD Addiction Cert Board)

The RPS credential is particularly important because:

• CPRS certification hours must be documented by an RPS
• Maryland Medicaid-reimbursable Peer Recovery Support Services require RPS oversight
• Peer supervision should address peer role fidelity in addition to administrative performance

Who Can Become an RPS?

MABPCB currently allows several pathways.

Eligible applicants may include certain clinical professionals or administrators with behavioral health supervisory experience.

CPRS holders seeking RPS status have additional requirements. MABPCB states that CPRS professionals generally must have completed their first two-year recertification and document qualifying experience supervising peers or serving as a lead peer before obtaining RPS status. (MD Addiction Cert Board)

Applicants must also complete an approved Registered Peer Supervisor training.

RPS Renewal

RPS status is renewed every two years.

Current requirements include an approved Supervising Peers refresher course.

A CPRS who holds RPS status must also maintain active CPRS certification. If the underlying CPRS fully expires, the associated RPS status may be revoked. (MD Addiction Cert Board)

Peer Supervision in Practice

Strong peer supervision should address more than administrative performance.

Peer supervision may include:

• Use of lived experience
• Boundaries
• Ethics
• Advocacy
• Recovery-oriented practice
• Harm reduction
• Relationship dynamics
• Role fidelity
• Community resource navigation
• Difficult peer relationships
• Personal wellness
• Burnout
• Documentation
• Crisis escalation

Administrative supervision may separately address:

• Scheduling
• Attendance
• Caseloads
• Documentation completion
• Organizational policies
• Performance
• Training completion

Clinical consultation may be appropriate when issues involve diagnosis, medication, clinical risk, treatment changes, or other areas outside the peer role.

Maryland recommends that organizations maintain sustainable supervisory caseloads. State Medicaid FAQ materials identify approximately three to four peers per RPS as a best-practice recommendation, although they note that there is not a specific regulatory maximum. (Maryland.gov Enterprise Agency Template)

Certified Peer Recovery Specialist – Family

Maryland also offers the Certified Peer Recovery Specialist – Family, or CPRS-F, endorsement.

The CPRS-F is not a completely separate entry-level peer credential.

Instead, it is an endorsement for someone who already holds an active CPRS and wants additional preparation to work with peers and families affected by behavioral health and recovery challenges. (MD Addiction Cert Board)

CPRS-F Requirements

MABPCB currently identifies:

• Active CPRS certification as a prerequisite
• Additional family-focused training
• 50 hours of service in a family service position or environment
• At least five documented family supervision hours from a Registered Peer Supervisor

The Board currently lists 25 training hours for the endorsement. (MD Addiction Cert Board)

Family-focused training spans areas such as:

• Advocacy
• Ethical responsibility
• Mentoring and education
• Recovery and wellness
• Harm reduction

What Does a Family Peer Do?

Family peer specialists may:

• Support family members affected by behavioral health conditions
• Help families understand recovery
• Promote family self-advocacy
• Help families navigate behavioral health systems
• Provide recovery education
• Connect family members with resources
• Support communication
• Help families understand multiple pathways to recovery
• Support healing and resilience
• Help families establish boundaries
• Provide support grounded in family lived experience

Family peer support remains distinct from family therapy, legal representation, case management, and other professional services.

Integrated Forensic Peer Recovery Specialist

Maryland also offers an Integrated Forensic Peer Recovery Specialist, or iFPRS, endorsement through MABPCB. (MD Addiction Cert Board)

This specialization is relevant to peer professionals working with people affected by:

• Criminal justice involvement
• Incarceration
• Reentry
• Drug courts
• Detention
• Community supervision
• Behavioral health and justice-system intersections

Maryland’s peer workforce has historically included Peer Recovery Specialists working in detention centers, drug courts, local health departments, community organizations, and other justice-related settings.

Organizations serving justice-involved populations should verify the current iFPRS eligibility and training requirements through MABPCB.

CPRS Recertification

Maryland CPRS certification must be renewed every two years. (MD Addiction Cert Board)

Current recertification requirements include continuing education across the relevant domains.

MABPCB currently identifies 20 hours of continuing education for CPRS recertification.

Organizations employing CPRS professionals should track:

• Certification number
• Original certification date
• Expiration date
• Continuing education
• Ethics training
• Harm reduction training where applicable
• Recertification application status
• RPS status if applicable
• Specialty endorsements

Allowing certification to expire can affect both a worker’s professional status and an organization’s ability to use that worker for Medicaid-reimbursable services.

Is Peer Support Covered by Maryland Medicaid?

Yes.

Maryland Medicaid reimburses certain Peer Recovery Support Services when all applicable requirements are satisfied.

The benefit became available for eligible providers beginning June 1, 2023. (Maryland.gov Enterprise Agency Template)

However, peer certification alone does not make every peer service Medicaid billable.

Maryland currently limits the dedicated Medicaid Peer Recovery Support Services benefit to qualifying enrolled provider organizations.

Medicaid-Eligible Provider Types

Current Maryland guidance identifies three major provider types eligible for dedicated Peer Recovery Support Services reimbursement:

Provider Type 50

Eligible community-based Substance Use Disorder Programs licensed under COMAR 10.63.03, including qualifying:

• Outpatient Level 1
• Intensive Outpatient Level 2.1
• Partial Hospitalization Level 2.5

Provider Type 32

Opioid Treatment Programs.

Provider Type 34

Federally Qualified Health Centers.

(Maryland.gov Enterprise Agency Template)

Organizations must be appropriately licensed and enrolled for the service.

Can an RCO Independently Bill Maryland Medicaid for Peer Support?

An organization should not assume that being a Recovery Community Organization, nonprofit, or peer-run organization automatically creates eligibility to bill Maryland Medicaid’s Peer Recovery Support Services benefit.

The dedicated Medicaid benefit is tied to specified provider types.

A standalone peer organization that is not enrolled as an eligible provider may need to:

• Operate through grant or contract funding
• Partner with an eligible Medicaid provider
• Become an eligible provider if legally and operationally appropriate
• Use another applicable funding model

The provider structure is therefore as important as the peer worker’s certification.

Who Can Deliver Medicaid Peer Recovery Support Services?

For the dedicated Maryland Medicaid benefit, services must be delivered by a Certified Peer Recovery Specialistcertified by MABPCB or another approved qualifying certification entity.

Medicaid guidance also requires supervision by a Registered Peer Supervisor. (Maryland.gov Enterprise Agency Template)

Providers are expected to maintain verification of both:

• CPRS certification
• RPS certification

Providers may also need to maintain required pre-employment background checks and other enrollment documentation. (Maryland.gov Enterprise Agency Template)

Maryland Medicaid Peer Support Codes

Maryland Medicaid established dedicated codes for individual and group Peer Recovery Support Services.

Current foundational guidance identifies:

(Maryland.gov Enterprise Agency Template)

Organizations should verify current rates and modifiers against the current Medicaid fee schedule and billing guidance before submitting claims because reimbursement amounts may change.

What Can Medicaid Peer Support Include?

Maryland’s Medicaid peer guidance identifies recovery-oriented activities such as:

• Recovery goal setting
• Skill building
• Recovery education
• Peer support
• Advocacy
• Helping members navigate services
• Culturally responsive support
• Facilitating peer support groups
• Connecting members with crisis resources
• Connecting members with community support
• Connecting members with other medically necessary services when appropriate

(Maryland.gov Enterprise Agency Template)

Services should reflect actual peer support rather than simply using a peer worker to perform unrelated administrative or clinical functions.

Adult Residential SUD Programs

Maryland has specific restrictions involving residential SUD services.

Current state Medicaid FAQs state that adult residential SUD providers cannot separately bill the dedicated Peer Recovery Support Services benefit because peer support is included within the residential per diem. (Maryland.gov Enterprise Agency Template)

Maryland also distinguishes among residential levels when a separate community SUD or OTP provider is delivering peer support concurrently.

State guidance currently permits separate peer reimbursement in certain circumstances for members receiving Level 3.1 residential services but restricts separate reimbursement with Level 3.3 or higher residential services. (Maryland.gov Enterprise Agency Template)

Organizations should verify current combination-of-services rules before billing concurrent services.

Can an Individual CPRS Bill Medicaid Directly?

Do not assume so.

A CPRS credential establishes that an individual meets Maryland’s professional peer certification requirements.

It does not, by itself, create independent Medicaid billing authority.

The dedicated Medicaid Peer Recovery Support Services benefit is billed through eligible enrolled provider organizations.

A worker should distinguish among:

• Working as a peer
• Holding CPRS certification
• Being qualified to render a Medicaid peer service
• Working for an enrolled Medicaid provider
• Having authority to submit Medicaid claims

These are separate questions.

Medicaid Provider Enrollment

Eligible providers must enroll specifically for Peer Recovery Support Services.

Current state materials require providers to document:

• Correct provider type
• Appropriate BHA license
• Peer Recovery Support Services attestation
• CPRS certification
• RPS certification
• Required background check information
• Other applicable enrollment materials

(Maryland.gov Enterprise Agency Template)

Maryland is also transitioning Medicaid provider enrollment from ePREP to the Maryland Provider Registration and Information Management Enterprise, or MPRIME, in October 2026. Maryland began holding certain provider enrollment applications during summer 2026 in preparation for the transition. (Maryland.gov Enterprise Agency Template)

Organizations planning Medicaid enrollment during this period should review the current MPRIME transition schedule before relying on older ePREP instructions.

Maryland Behavioral Health Licensing

Maryland’s Behavioral Health Administration licenses and certifies community behavioral health programs under COMAR 10.63.

Licenses are site-specific and service-specific. (Maryland.gov Enterprise Agency Template)

This matters for peer organizations because Medicaid eligibility may depend partly on the organization’s underlying behavioral health provider status.

Maryland has also been actively revising the COMAR 10.63 regulations throughout 2026.

BHA published revised draft regulations in January, April, May, and later updates in 2026. (Maryland.gov Enterprise Agency Template)

Organizations should therefore verify the final currently effective regulations before using draft 2026 language as a compliance standard.

Scope of Practice for Maryland Peer Recovery Specialists

Maryland CPRS professionals provide recovery-oriented support grounded in lived experience.

Depending on the program, peers may:

• Engage participants
• Build trusting relationships
• Share relevant lived experience
• Support recovery goals
• Promote self-advocacy
• Provide mentoring
• Provide recovery education
• Support wellness
• Support harm reduction
• Help participants navigate behavioral health systems
• Connect participants with resources
• Facilitate peer support groups
• Support community participation
• Support transitions
• Help build natural supports
• Help participants prepare for appointments or meetings
• Support recovery planning
• Participate in multidisciplinary teams
• Document peer services

Activities Generally Outside the Peer Role

Unless separately licensed and acting within another professional role, a CPRS generally should not:

• Diagnose mental health or substance use disorders
• Conduct psychotherapy
• Prescribe medication
• Provide medical advice as a healthcare professional
• Conduct clinical assessments requiring licensure
• Make involuntary treatment decisions
• Represent themselves as a licensed clinician
• Make legal determinations
• Determine Medicaid eligibility
• Independently alter clinical treatment plans
• Perform unrelated duties that undermine peer role fidelity

Harm Reduction and Maryland Peer Support

Harm reduction has become more explicit within Maryland’s professional peer framework.

Effective September 1, 2025, MABPCB added a dedicated four-hour Harm Reduction domain to CPRS certification requirements and additional supervision requirements associated with the expanded competency model. (MD Addiction Cert Board)

This means harm reduction is no longer simply an optional topic in Maryland’s CPRS training structure.

Peer workers may support participants by:

• Providing nonjudgmental support
• Helping participants identify safer choices
• Connecting people with harm reduction resources
• Supporting multiple pathways to recovery
• Connecting people with overdose prevention services
• Supporting naloxone access and education when consistent with their role and program
• Maintaining engagement when abstinence is not the participant’s current goal

The precise activity should remain consistent with organizational policy, training, and applicable service requirements.

Documentation for Maryland Peer Support Services

Maryland Medicaid expects Peer Recovery Support Services to be documented.

State Medicaid FAQ materials recommend that organizations use their existing electronic health record and follow applicable documentation requirements. (Maryland.gov Enterprise Agency Template)

A peer progress note may include:

• Participant name or identifier
• Date of service
• Start and end time
• Duration
• Location
• Individual or group service
• Relevant recovery goal
• Peer intervention
• Recovery-oriented activity
• Relevant use of lived experience
• Skill building
• Advocacy
• Resources or referrals
• Participant response
• Progress
• Follow-up plan
• Peer worker name
• CPRS credential
• Required signature or attestation

Peer Documentation Should Be

• Accurate
• Timely
• Recovery-oriented
• Person-centered
• Strengths-based
• Respectful
• Relevant
• Specific
• Consistent with peer scope
• Connected to the service delivered
• Consistent with Medicaid or payer requirements

Peer Documentation Should Avoid

• Unsupported diagnoses
• Clinical interpretation outside peer scope
• Stigmatizing language
• Identical copied notes
• Unnecessary trauma details
• Exaggerating or inventing services
• Personal opinions presented as clinical facts
• Notes that fail to describe the actual peer intervention
• Documentation written solely to fit a billing code

Documentation and Billing Are Not the Same Thing

A complete peer support progress note does not automatically establish that a claim is payable.

A Medicaid claim may additionally depend on:

• Participant eligibility
• Provider enrollment
• Provider type
• BHA licensure
• CPRS status
• RPS supervision
• Medical necessity
• Service eligibility
• Correct code
• Correct modifier
• Correct units
• Place of service
• Concurrent-service limitations
• Timely filing
• Other Medicaid requirements

Organizations should separately validate service delivery, documentation quality, and claims eligibility.

Confidentiality and Information Sharing

Maryland peer programs may handle highly sensitive behavioral health and substance use information.

Applicable requirements may include:

• HIPAA
• 42 CFR Part 2
• Maryland confidentiality law
• Maryland Medicaid requirements
• Organizational privacy policies
• Consent and authorization rules
• Requirements involving minors
• Contractual confidentiality requirements

Peer workers should receive role-specific training covering:

• What information they may access
• What should be documented
• What information may be shared
• Participant consent
• Communication with care teams
• Substance use records
• Text messaging
• Email
• Telehealth
• Social media
• Crisis situations
• Court and legal requests

Organizations should obtain qualified legal and compliance guidance for their specific programs.

Where Peer Support Is Delivered in Maryland

Maryland Peer Recovery Specialists work across a wide range of settings.

Community-Based Substance Use Disorder Programs

CPRS professionals can provide Medicaid-reimbursable Peer Recovery Support Services within eligible community SUD programs enrolled as Provider Type 50. (Maryland.gov Enterprise Agency Template)

Opioid Treatment Programs

OTPs enrolled as Provider Type 32 may provide reimbursable Peer Recovery Support Services when all requirements are met. (Maryland.gov Enterprise Agency Template)

Peers in OTPs may support:

• Treatment engagement
• Recovery goals
• Medication-supported recovery
• Harm reduction
• Community connection
• Resource navigation
• Retention
• Recovery planning

Federally Qualified Health Centers

Maryland has expanded the dedicated peer reimbursement pathway to qualifying Federally Qualified Health Centers, Provider Type 34. (Maryland.gov Enterprise Agency Template)

Recovery Community Organizations

RCOs may provide:

• Recovery coaching
• Peer groups
• Recovery activities
• Resource navigation
• Community events
• Telephone recovery support
• Advocacy
• Education
• Recovery capital development

A standalone RCO’s ability to bill Medicaid depends on whether it separately meets the provider requirements for a covered benefit.

Local Health Departments

Maryland local health departments use Peer Recovery Specialists in behavioral health and recovery programs.

For example, Carroll County Health Department operates Peer Recovery Support Services for adults with substance use and mental health recovery needs. (Maryland.gov Enterprise Agency Template)

Hospitals and Emergency Departments

Peer professionals may work in hospitals and emergency departments supporting people after:

• Overdose
• Substance-related emergencies
• Psychiatric crisis
• Behavioral health hospitalization

Services may include engagement, recovery support, referral, treatment connection, and follow-up.

Recovery Residences

Peer professionals may support residents living in recovery housing.

The peer role should remain distinct from housing management, rule enforcement, or other responsibilities that could create conflicts with mutual peer relationships.

Crisis Services

Peers may participate in behavioral health crisis services where permitted by the applicable program.

Roles may involve:

• Engagement
• Emotional support
• Sharing lived experience
• Recovery-oriented communication
• Resource connections
• Post-crisis support
• Warm handoffs

Justice and Reentry

Maryland’s Integrated Forensic Peer Recovery Specialist pathway supports development of peer expertise at the intersection of behavioral health and criminal justice.

Peer professionals may work in:

• Detention centers
• Drug courts
• Reentry programs
• Community supervision programs
• Diversion programs
• Other justice-related settings

Community and Nonprofit Organizations

Peers may work through:

• Local nonprofits
• Recovery community centers
• Wellness recovery centers
• Supportive housing
• Community organizations
• Grant-funded recovery initiatives

Not all peer work needs to be Medicaid reimbursed.

Some organizations intentionally maintain grant-funded or community-funded peer services to preserve flexibility in service delivery.

Developmental Disabilities Peer Mentoring

Maryland also supports Family and Peer Mentoring Supports through the Developmental Disabilities Administration.

This is distinct from the CPRS Medicaid behavioral health benefit.

DDA describes Family and Peer Mentoring Supports as connecting participants and unpaid family caregivers with mentors who have similar lived experience. Mentors help people navigate systems, community resources, and services while building skills and confidence. (Maryland.gov Enterprise Agency Template)

Organizations should not treat DDA mentoring and behavioral health CPRS services as the same benefit simply because both involve lived-experience support.

Starting a Peer Support Program in Maryland

Organizations developing a Maryland peer support program should begin with the population and service model rather than a Medicaid code.

Step 1: Define the Population

Determine whether the program serves:

• Adults with mental health conditions
• People with substance use disorders
• People with co-occurring conditions
• Families
• People involved in the justice system
• People leaving hospitals
• People in recovery residences
• People receiving medications for opioid use disorder
• People seeking community-based recovery
• Other defined populations

Step 2: Define the Peer Role

Determine whether staff need:

• CPRS certification
• CPRS-F endorsement
• iFPRS specialization
• Another relevant qualification
• A pathway to accumulate CPRS hours

Step 3: Determine the Funding Model

Potential funding sources may include:

• Maryland Medicaid
• Behavioral Health Administration funding
• Local health department funding
• Federal block grants
• Opioid settlement funding
• Local government
• Hospital funding
• Grants
• Philanthropy
• Contracts
• Private payment

Each funding source may establish different requirements.

Step 4: Determine Whether Medicaid Billing Applies

For dedicated Peer Recovery Support Services, determine whether the organization is an eligible:

• Provider Type 32
• Provider Type 50
• Provider Type 34

If not, Medicaid’s dedicated peer benefit may not be directly available to the organization.

Step 5: Build the Workforce

Determine:

• CPRS requirements
• CORE training
• Five-domain education
• Service hours
• Supervision
• Examination
• Certification timeline
• RPS availability
• Recertification
• Specialty endorsements

Step 6: Establish Supervision

Determine:

• Who serves as RPS
• How frequently supervision occurs
• How supervision is documented
• How peer role fidelity is addressed
• How clinical escalation occurs
• How supervision supports staff wellness

Organizations helping workers earn CPRS certification should ensure the RPS documentation process is in place before service hours accumulate.

Step 7: Design the Workflow

Map:

• Referral
• Intake
• Eligibility
• Consent
• Peer assignment
• Matching
• Scheduling
• Service delivery
• Documentation
• Supervision
• Escalation
• Follow-up
• Transition
• Outcomes
• Billing

Step 8: Establish Role Boundaries

Create written policies addressing:

• Use of lived experience
• Scope of practice
• Harm reduction
• Confidentiality
• Crisis response
• Transportation
• Gifts
• Social media
• Dual relationships
• Communication after hours
• Home and community visits
• Staff wellness
• Role drift

Step 9: Track Credentials

Organizations should monitor:

• CPRS status
• Certification number
• Certification expiration
• Training domains
• Service hours for developing peers
• Supervision hours
• RPS certification
• CPRS-F endorsement
• iFPRS endorsement
• Continuing education
• Background checks
• Medicaid enrollment requirements

Step 10: Measure Outcomes

Useful measures may include:

• Referral-to-contact time
• Engagement
• Retention
• Treatment initiation
• Treatment retention
• Recovery capital
• Community connection
• Participant-defined progress
• Harm reduction engagement
• Successful transitions
• Recovery housing stability
• Satisfaction
• Referral outcomes
• Peer workforce retention
• Documentation timeliness
• Supervision completion

Common Challenges for Maryland Peer Programs

Certification Complexity

The CPRS credential requires training, service hours, supervision, examination, and documentation.

Organizations frequently employ workers before they have completed the full credentialing process.

A strong program should help workers build a clear path toward certification.

2025 CPRS Requirement Changes

Organizations using older certification checklists may still refer to:

• 46 training hours
• Four domains
• 25 supervision hours

Those figures are outdated for applications submitted after September 1, 2025.

Current requirements use:

• 50 training hours
• Five domains
• 30 supervision hours

(MD Addiction Cert Board)

Supervisory Capacity

Every developing or Medicaid-billing peer workforce needs adequate supervision.

An organization can hire multiple peers quickly but may lack enough Registered Peer Supervisors to support certification, quality, and Medicaid compliance.

Medicaid Provider Restrictions

Maryland’s dedicated Medicaid Peer Recovery Support Services benefit is not universally available to every peer organization.

Provider eligibility is a significant limitation for standalone RCOs and community organizations.

Medicaid Enrollment Transition

The 2026 transition from ePREP to MPRIME creates a temporary administrative challenge for organizations enrolling or modifying Medicaid provider information. (Maryland.gov Enterprise Agency Template)

Documentation Burden

Peer professionals enter the workforce because of their ability to build trusting relationships.

Poorly designed documentation can shift substantial time away from direct peer engagement.

Role Drift

Peers may gradually be assigned:

• Case management
• Administrative work
• Transportation
• Clinical monitoring
• Surveillance
• Other duties inconsistent with peer practice

Organizations should actively protect peer role fidelity.

Fragmented Technology

Programs may use separate tools for:

• Referral
• Intake
• Scheduling
• Documentation
• Supervision
• Certification tracking
• Participant communication
• Groups
• Outcomes
• Claims
• Grant reporting

This creates avoidable administrative burden for both peers and supervisors.

Demonstrating Outcomes

Traditional clinical outcomes do not capture all the value created by peer support.

Programs may also need to measure:

• Recovery capital
• Hope
• Self-efficacy
• Connection
• Engagement
• Community participation
• Resource access
• Recovery stability
• Participant-defined progress

Frequently Asked Questions

What is Maryland’s peer support credential?

Maryland’s primary peer credential is the Certified Peer Recovery Specialist, or CPRS. It is administered by the Maryland Addiction and Behavioral-health Professionals Certification Board. (MD Addiction Cert Board)

Is Maryland’s CPRS only for substance use recovery?

No.

Maryland’s CPRS credential is broader than an exclusively SUD-specific recovery coach credential and may involve mental health, substance use, and co-occurring behavioral health recovery.

How many training hours are required?

For applications submitted after September 1, 2025, applicants need 50 hours across five domains. (MD Addiction Cert Board)

What are the five CPRS training domains?

They are:

• Advocacy
• Ethical Responsibility
• Mentoring and Education
• Recovery and Wellness
• Harm Reduction

(MD Addiction Cert Board)

How many peer work hours are required?

Current MABPCB requirements call for 500 documented supervised peer recovery service hours completed within the two years before application. (MD Addiction Cert Board)

How many supervision hours are required?

Current CPRS applicants need 30 documented supervision hours from a Registered Peer Supervisor. (MD Addiction Cert Board)

Do applicants need a CORE training?

Yes. Current MABPCB requirements include at least one approved CORE peer training. (MD Addiction Cert Board)

Does Maryland require an exam?

Yes. CPRS certification includes an examination requirement. (SAMHSA)

How often must CPRS certification be renewed?

Every two years. (MD Addiction Cert Board)

What is a Registered Peer Supervisor?

An RPS is the Maryland credential for professionals qualified to supervise Peer Recovery Specialists. (MD Addiction Cert Board)

Does a CPRS have to be supervised twice a month?

MABPCB’s current certification requirements state that peers pursuing certification should receive documented supervision at least twice monthly. (MD Addiction Cert Board)

Does Maryland have a family peer credential?

Yes. Maryland offers the CPRS-F endorsement for people who already hold an active CPRS and complete additional family-focused requirements. (MD Addiction Cert Board)

Does Maryland have a forensic peer credential?

Maryland offers an Integrated Forensic Peer Recovery Specialist endorsement. (MD Addiction Cert Board)

Is peer support covered by Maryland Medicaid?

Yes. Maryland Medicaid reimburses qualifying Peer Recovery Support Services delivered through eligible enrolled providers. (Maryland.gov Enterprise Agency Template)

Which providers can bill the dedicated Medicaid peer benefit?

Current guidance includes eligible:

• Community-based SUD providers, Provider Type 50
• Opioid Treatment Programs, Provider Type 32
• Federally Qualified Health Centers, Provider Type 34

(Maryland.gov Enterprise Agency Template)

What code is used for individual peer support?

Maryland’s dedicated Medicaid Peer Recovery Support Services guidance uses H0038/SC for individual services in 15-minute units. (Maryland.gov Enterprise Agency Template)

What code is used for group peer support?

Maryland uses H0024/SC for group Peer Recovery Support Services in 15-minute units. (Maryland.gov Enterprise Agency Template)

Can a CPRS bill Medicaid independently?

Do not assume so.

The dedicated Medicaid peer benefit is delivered through eligible enrolled provider organizations.

Can a Recovery Community Organization bill Medicaid?

Not automatically.

The organization must independently satisfy the applicable Maryland Medicaid provider and enrollment requirements.

Can residential SUD providers separately bill peer support?

Maryland’s current Medicaid FAQ states that adult residential SUD providers do not separately bill the dedicated peer service because peer support is included in the residential per diem. (Maryland.gov Enterprise Agency Template)

Can peers work in hospitals?

Yes. Maryland Peer Recovery Specialists work in hospital and emergency department programs.

Can peers work in local health departments?

Yes. Local health departments across Maryland operate Peer Recovery Support Services and other peer programs. (Maryland.gov Enterprise Agency Template)

Can peers work with people who use medications for opioid use disorder?

Yes. Peer recovery support should not automatically exclude medication-supported recovery.

Does Maryland require harm reduction training?

Harm Reduction became a formal CPRS certification domain effective September 1, 2025, with four required training hours. (MD Addiction Cert Board)

Can peers write progress notes?

Yes. Peer workers providing reimbursable services are expected to document those services. Maryland recommends using the organization’s existing EHR while following applicable documentation requirements. (Maryland.gov Enterprise Agency Template)

Are CPRS professionals clinicians?

No. CPRS certification itself is not a clinical professional license.

Can peer support be provided virtually?

Potentially, depending on the service and current payer rules.

Organizations should verify current Medicaid telehealth, place-of-service, consent, privacy, and documentation requirements before billing virtual peer support.

What is changing with Maryland Medicaid enrollment in 2026?

Maryland is replacing ePREP with the new MPRIME provider enrollment system in October 2026. Enrollment application holds began during summer 2026 as part of the transition. (Maryland.gov Enterprise Agency Template)

Official Maryland Peer Support Resources

Certification and Training

Maryland Addiction and Behavioral-health Professionals Certification Board

Maryland’s behavioral health credentialing organization responsible for Certified Peer Recovery Specialist certification, Registered Peer Supervisor designation, CPRS-F, forensic peer specialization, approved trainings, credential verification, and certification renewal.

Last checked: August 19, 2026. (MD Addiction Cert Board)

Certified Peer Recovery Specialist

Official MABPCB resource detailing current CPRS eligibility, 50-hour training requirements, 500 service hours, 30 supervision hours, CORE training, examination, application, and recertification.

Last checked: August 19, 2026. (MD Addiction Cert Board)

September 2025 CPRS Requirements Update

Official MABPCB announcement explaining the addition of the Harm Reduction domain, increase from 46 to 50 training hours, and increase from 25 to 30 supervision hours for applications submitted after September 1, 2025.

Last checked: August 19, 2026. (MD Addiction Cert Board)

Registered Peer Supervisor

Official MABPCB resource describing RPS eligibility, approved supervisor training, supervision documentation, renewal, and responsibilities.

Last checked: August 19, 2026. (MD Addiction Cert Board)

Certified Peer Recovery Specialist – Family

Official MABPCB resource for the CPRS-F endorsement, including active CPRS prerequisite, family-specific training, service hours, and supervision requirements.

Last checked: August 19, 2026. (MD Addiction Cert Board)

MABPCB Certification Resources

Official MABPCB resource library containing current CPRS exam materials, competency information, ethics materials, CPRS-F resources, forensic peer materials, and RPS resources.

Last checked: August 19, 2026. (MD Addiction Cert Board)

University of Maryland Peer Recovery Specialist Training

University of Maryland Training Center program developed with the Maryland Behavioral Health Administration to provide peer-specific training toward CPRS certification.

Last checked: August 19, 2026. (Training Center)

Medicaid and Reimbursement

Maryland Medicaid Peer Recovery Support Services

Official Maryland Medicaid guidance describing the dedicated Peer Recovery Support Services benefit, eligible provider types, CPRS and RPS requirements, enrollment, and reimbursement structure.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

Maryland Peer Medicaid Reimbursement FAQs

State FAQ addressing Medicaid peer reimbursement, supervision, documentation, residential SUD services, certification navigation, age questions, and implementation.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

Maryland Medicaid Provider Information

Official Medicaid provider resource containing manuals, enrollment information, forms, and provider-specific requirements.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

MPRIME Provider Enrollment Transition

Official Maryland Medicaid resource explaining the 2026 transition from ePREP to the MPRIME enrollment system, including application holds and the October 2026 go-live.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

State Agencies

Maryland Department of Health

State health agency overseeing Medicaid, public health, behavioral health, developmental disabilities, and other health programs.

Last checked: August 19, 2026.

Maryland Behavioral Health Administration

Maryland’s behavioral health authority responsible for major portions of the state’s mental health, substance use, recovery, behavioral health licensing, and peer workforce infrastructure.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

Maryland Medicaid

State Medicaid program responsible for eligibility, provider enrollment, coverage, reimbursement, and behavioral health Medicaid policy.

Last checked: August 19, 2026.

Behavioral Health and Community Resources

COMAR 10.63 Community Behavioral Health Programs

Official Behavioral Health Administration resource explaining Maryland community behavioral health licensure and current regulatory requirements.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

Maryland COMAR 10.63 Regulatory Updates

Official state page tracking Maryland’s ongoing 2026 revision process for community behavioral health regulations.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

DDA Family and Peer Mentoring Supports

Maryland Developmental Disabilities Administration service supporting people with intellectual and developmental disabilities and their families through mentors with similar lived experience.

Last checked: August 19, 2026. (Maryland.gov Enterprise Agency Template)

Resource Links

Maryland Addiction and Behavioral-health Professionals Certification Boardhttps://www.mabpcb.com/

Maryland Certified Peer Recovery Specialisthttps://www.mabpcb.com/certified-peer-recovery-specialist-cprs

2025 CPRS Requirements Updatehttps://www.mabpcb.com/new-cprs-requirements-effective-september-1-2025

Registered Peer Supervisorhttps://www.mabpcb.com/registered-peer-supervisor

Certified Peer Recovery Specialist – Familyhttps://www.mabpcb.com/certified-peer-recovery-specialist-family-cprs-f

MABPCB Certificationshttps://www.mabpcb.com/certifications

University of Maryland Peer Recovery Specialist Traininghttps://trainingcenter.umaryland.edu/training-and-education/peer-recovery-specialist/

Maryland Medicaid Provider Informationhttps://health.maryland.gov/mmcp/Pages/Provider-Information.aspx

MPRIME Provider Enrollment Informationhttps://health.maryland.gov/mmcp/provider/Pages/mprime.aspx

Maryland COMAR 10.63 Behavioral Health Programshttps://health.maryland.gov/bha/Pages/COMAR-10-63-Programs-.aspx

Technology for Maryland Peer Support Programs

Maryland’s peer infrastructure creates several operational requirements that traditional clinical software may not handle well.

Technology supporting Maryland peer programs should account for:

• Certified Peer Recovery Specialists
• People working toward CPRS certification
• Registered Peer Supervisors
• CPRS-F endorsements
• Forensic peer endorsements
• Five CPRS competency domains
• CORE training
• 500 service-hour accumulation
• 30 supervision-hour accumulation
• Twice-monthly supervision
• Certification examinations
• Certification expiration dates
• Continuing education
• RPS renewal
• Peer-specific documentation
• Individual and group peer services
• H0038/SC
• H0024/SC
• 15-minute billing units
• Provider Type 32
• Provider Type 50
• Provider Type 34
• Medicaid enrollment
• Participant eligibility
• Referrals
• Caseloads
• Scheduling
• Groups
• Recovery plans
• Participant communication
• Recovery capital
• Outcomes
• Grant reporting
• Medicaid claims
• Role-based permissions
• HIPAA
• 42 CFR Part 2
• Community-based workflows

Maryland’s certification structure creates a particularly strong need for integrated workforce tracking.

An organization may employ someone who has completed a CORE training but still needs:

• Additional domain hours
• Service hours
• Supervision
• Examination
• Final CPRS certification

A system that records only whether the worker is “certified” or “not certified” misses the actual workforce development process.

Programs also need to distinguish between:

• CPRS supervision used toward certification
• Ongoing peer practice supervision
• Administrative supervision
• Clinical consultation
• Medicaid-required service oversight

Maryland’s Medicaid structure creates another operational challenge because the billability of peer support depends on the worker, supervisor, provider organization, member, service, and documentation.

A well-designed peer platform should be able to connect these components without forcing Peer Recovery Specialists into documentation designed solely for clinicians.

About Peerakeet

Peerakeet builds infrastructure for organizations delivering peer support and recovery services.

The platform supports peer-specific documentation, program workflows, supervision, participant engagement, scheduling, reporting, credential management, billing workflows, and day-to-day operations.

Peerakeet does not determine whether a Maryland service is billable and does not replace guidance from the Maryland Department of Health, Behavioral Health Administration, Maryland Medicaid, MABPCB, attorneys, compliance professionals, or applicable state and federal agencies.

Editorial Disclaimer

This guide is provided for general educational purposes. It is not legal, billing, credentialing, clinical, or regulatory advice.

Maryland peer support requirements may vary by service, payer, provider type, credential, contract, workforce role, setting, and program.

Maryland changed CPRS credentialing requirements in September 2025, is actively revising portions of its behavioral health regulatory structure, and is transitioning Medicaid provider enrollment systems during 2026.

Organizations should therefore verify current requirements rather than relying on older CPRS checklists, Medicaid enrollment instructions, COMAR drafts, or reimbursement materials.

Organizations and peer professionals should verify current requirements with the Maryland Behavioral Health Administration, Maryland Medicaid, MABPCB, current COMAR regulations, applicable contracts, and qualified professional advisors.

Last reviewed: August 2026.