New Hampshire Peer Support & Medicaid Guide

New Hampshire has a particularly developed peer support ecosystem spanning mental health, substance use recovery, Recovery Community Organizations, Peer Support Agencies, community mental health centers, hospitals, crisis services, recovery housing, drug courts, and other community settings.

The state is notable because it maintains two distinct formal peer workforce pathways:

Peer Support Specialist, primarily associated with mental health peer support
Certified Recovery Support Worker, or CRSW, primarily associated with substance use disorder recovery support

These roles are related but are not interchangeable.

Mental health Peer Support Specialists operate within a system overseen by the New Hampshire Department of Health and Human Services, or NH DHHS, including state-funded Peer Support Agencies and Community Mental Health Programs. New Hampshire transitioned its mental health peer certification process to a standardized Peer Support Specialist certificate program delivered through the state’s community college system. (NH Health and Human Services)

The Certified Recovery Support Worker is a state-regulated credential for people providing substance use recovery support. CRSW certification is administered through the New Hampshire Office of Professional Licensure and Certification under the Board of Licensing for Alcohol and Other Drug Use Professionals. State rules require qualifying education, peer recovery experience, examination, and other application requirements. (New Hampshire General Court)

New Hampshire Medicaid also recognizes recovery support services delivered by CRSW professionals and peer support services across portions of its mental health and children’s behavioral health system. Current Medicaid rules allow qualifying recovery support services to be delivered through enrolled outpatient SUD programs, comprehensive SUD programs, or peer recovery programs. (New Hampshire General Court)

New Hampshire Peer Support Quick Facts

Category	New Hampshire overview
State Medicaid program	New Hampshire Medicaid
State behavioral health authority	New Hampshire DHHS
Mental health peer role	Peer Support Specialist
Mental health peer certification	NH Peer Support Specialist Certification
Primary SUD peer credential	Certified Recovery Support Worker
Abbreviation	CRSW
CRSW regulatory authority	Board of Licensing for Alcohol and Other Drug Use Professionals
CRSW credentialing agency	NH Office of Professional Licensure and Certification
CRSW education	46 hours
CRSW experience	500 hours paid or volunteer
CRSW education minimum	High school diploma or equivalent
CRSW examination	Required
Mental health peer training	NH Peer Support Specialist certificate program
Mental health Peer Support Agencies	Yes
Recovery Community Organizations	Yes
Medicaid SUD peer coverage	Yes
Medicaid SUD peer code	H0038 in applicable services
Group SUD peer code	H0038 HQ in applicable services
Youth peer support	Medicaid-recognized in applicable programs
Family peer support	Medicaid-recognized in applicable programs
Mobile crisis peer workforce	Yes
Recovery coaching	Core RCO service
Last reviewed	August 2026

What Is Peer Support in New Hampshire?

Peer support is assistance provided by people whose relevant lived experience informs how they support someone else.

New Hampshire’s peer infrastructure reflects two overlapping traditions.

Mental health peer support emphasizes:

Mutuality
Shared experience
Self-determination
Wellness
Non-medical approaches
Choice
Community inclusion
Self-advocacy
Relationships based on trust and respect

New Hampshire’s Peer Support Agency rules specifically describe peer support as services provided for peers and by peers, designed to assist people in recovery through educational environments, wellness strategies, and mutually beneficial relationships. (New Hampshire General Court)

Substance use recovery support emphasizes:

Recovery coaching
Recovery planning
Treatment navigation
Recovery capital
Mutual support
Community connection
Advocacy
System navigation
Harm reduction
Multiple pathways to recovery
Ongoing recovery monitoring

New Hampshire’s state-funded Recovery Community Organizations are peer-led and peer-run organizations providing free, low-barrier recovery services to people who want support with recovery from substance misuse. (NH Health and Human Services)

Peer support should remain distinct from psychotherapy, diagnosis, medication management, and other services requiring professional clinical licensure.

New Hampshire Has Two Major Peer Workforce Systems

Understanding New Hampshire requires separating the state’s mental health peer system from its substance use recovery peer system.

The major roles are:

Peer Support Specialist
Certified Recovery Support Worker
Peer Support Agency staff
Recovery Community Organization peer recovery coaches
Youth Peer Support workers
Family Peer Support workers
Peer specialists working on mobile crisis teams
Peer specialists in Community Mental Health Programs
Recovery peers working in hospitals, treatment programs, drug courts, and community settings

Organizations should identify the specific service first, then determine the applicable peer qualification.

Mental Health Peer Support Specialists

New Hampshire maintains a formal mental health Peer Support Specialist workforce.

The state developed a standardized Peer Support Specialist certificate program through the New Hampshire Community College system.

NH DHHS describes this certificate program as replacing the prior training and certification examination requirements for new Certified Peer Support Specialists. (NH Health and Human Services)

The certification program includes nine major training modules covering areas such as:

Foundations of peer support
Communication and relationship building
Wellness and whole health
Recovery planning
Sharing lived experience
Crisis and crisis support
Suicide prevention
Ethics and boundaries
Co-occurring substance misuse

(NH Health and Human Services)

New peers seeking state Peer Support Specialist certification are expected to successfully complete the program within the applicable employment timeframe.

How New Hampshire Mental Health Peer Certification Works

Current NH DHHS guidance states that peers seeking certification must:

Enroll in the Peer Support Specialist certificate program offered through the New Hampshire Community College system.
Successfully complete all required modules and virtual course meetings.
Have completion reported to NH DHHS by the community college.
Receive official Peer Support Specialist certification status from the Department.

(NH Health and Human Services)

The program was created to standardize peer workforce preparation across the state’s mental health system.

People who were already certified before the new program was implemented are not required to repeat the new certification curriculum. (NH Health and Human Services)

Mental Health Peer Professional Development

New Hampshire requires ongoing professional development through employer and program requirements.

NH DHHS guidance directs Peer Support Specialists to applicable requirements in state mental health rules, including He-M 402 and He-M 426. (NH Health and Human Services)

The state has also developed a Peer Community of Practice intended to support continuing learning, collaboration, and professional development among peer workers and supervisors.

Organizations should separately track:

Initial certification
Employer training
Continuing professional development
Specialty training
Crisis training
Supervision
Any Intentional Peer Support training maintained independently

Intentional Peer Support in New Hampshire

Intentional Peer Support, commonly called IPS, has historically been important within New Hampshire’s mental health peer system.

However, IPS is not currently required as a component of the state’s newer Peer Support Specialist certification program.

NH DHHS specifically notes that people who independently want to maintain IPS certification must satisfy IPS-specific co-reflection requirements, but this is separate from the New Hampshire state certification pathway. (NH Health and Human Services)

Organizations should therefore distinguish between:

State Peer Support Specialist certification
Intentional Peer Support training or certification
Employer-specific training

Peer Support Agencies

New Hampshire has a formal network of Peer Support Agencies, commonly abbreviated PSAs.

State rules define a Peer Support Agency as an organization whose primary purpose is providing culturally competent peer support to adults with lived experience involving publicly funded mental health services. (New Hampshire General Court)

Peer Support Agencies are designed around a nonclinical and peer-led philosophy.

The state’s rules emphasize:

Shared decision-making
Mutuality
Non-medical approaches
Choice
Autonomy
Independence
Community inclusion
Hope
Holistic wellness
Informed decision-making

(New Hampshire General Court)

Who Can Use a Mental Health Peer Support Agency?

New Hampshire’s Peer Support Agency rules define a peer as someone age 18 or older who self-identifies as:

A former recipient of publicly funded mental health services
A current recipient
Or someone at significant risk of becoming a recipient of publicly funded mental health services

(New Hampshire General Court)

State-funded PSAs similarly describe their services as available to adults with mental health challenges who identify with the public mental health system. (NH Health and Human Services)

What Do Peer Support Agencies Provide?

New Hampshire requires PSAs to provide several core services.

These include:

Face-to-face peer support
Telephone peer support
Outreach
Individual peer assistance
Wellness training
Educational events
Self-advocacy activities
Community resource connection

(New Hampshire General Court)

State guidance also describes additional services available through parts of the network, including:

Warm lines
Peer respite
Step-Up Step-Down programs
Vocational support
Residential support

(New Hampshire General Court)

Peer Respite

New Hampshire allows Peer Support Agencies to operate peer respite programs.

State rules describe peer respite as a:

24-hour
Short-term
Non-medical

alternative intended to support people experiencing psychiatric crises. (New Hampshire General Court)

Peer respite is designed around peer relationships rather than hospitalization or traditional clinical crisis care.

Programs should separately verify current state contracting, staffing, safety, admission, and operational requirements.

Step-Up Step-Down

New Hampshire’s peer infrastructure also includes Step-Up Step-Down programs.

These provide peer-oriented alternatives or transitions between community living and higher-acuity behavioral health treatment.

State peer materials identify Step-Up Step-Down programs operating through portions of New Hampshire’s Peer Support Agency network. (NH Health and Human Services)

These programs may help people:

Avoid hospitalization
Transition out of hospitalization
Stabilize in a peer environment
Reconnect with community supports
Build wellness strategies
Develop recovery plans

Certified Recovery Support Worker

The Certified Recovery Support Worker, or CRSW, is New Hampshire’s professional substance use recovery peer credential.

State law defines a CRSW as an individual certified by the Office of Professional Licensure and Certification to provide recovery support to people with substance use disorders. (New Hampshire General Court)

Unlike the mental health Peer Support Specialist certificate, the CRSW is regulated through the state’s professional licensing framework.

Only people appropriately certified may use the title Certified Recovery Support Worker or abbreviation CRSW. (New Hampshire General Court)

CRSW Eligibility

Current New Hampshire administrative rules require an applicant for initial CRSW certification to have:

A high school diploma or equivalent
At least 500 hours of qualifying paid or volunteer work experience
At least 46 hours of qualifying education
A completed application
Successful examination
Satisfactory evaluations demonstrating competency in peer recovery support work

(New Hampshire General Court)

The state also requires criminal background screening as part of the certification process. (New Hampshire General Court)

CRSW Education Requirement

New Hampshire requires at least 46 hours of education for initial CRSW certification. (New Hampshire General Court)

Training is designed around the major competency domains of professional peer recovery support.

Topics may include:

Advocacy
Mentoring and education
Recovery and wellness
Ethical responsibility
Recovery planning
Communication
Boundaries
Resource navigation
Recovery capital
Multiple pathways to recovery
Professional peer practice

Organizations should verify current Board rules and approved education standards before determining whether a particular course satisfies certification requirements.

CRSW Experience Requirement

New Hampshire requires at least 500 hours of paid or volunteer recovery support work experience within the applicable timeframe for initial certification. (New Hampshire General Court)

This means completing recovery coach training alone does not automatically result in CRSW certification.

Applicants must satisfy both:

Education requirements
Practical peer recovery experience requirements

CRSW Examination

New Hampshire requires a qualifying certification examination.

State occupational guidance identifies the IC&RC Peer Recovery examination as the applicable examination for CRSW certification. (New Hampshire Employment Security)

Organizations should use current Board guidance for examination scheduling, fees, and application procedures.

Criminal Background Check

Initial CRSW certification includes state and federal criminal history review.

Current rules require submission of fingerprints and the applicable criminal history release information through the state’s certification process. (New Hampshire General Court)

Organizations should distinguish between:

State professional certification background requirements
Employer background requirements
Medicaid provider requirements
Program-specific screening

CRSW Scope of Practice

CRSW professionals provide recovery support to people with substance use disorders.

Peer recovery support may include:

Recovery coaching
Recovery planning
Recovery goal development
Treatment navigation
Mutual support connection
Recovery capital development
Advocacy
Resource navigation
Harm reduction
Employment and housing support
Community connection
Wellness
Telephone recovery support
Transition support
Supporting multiple pathways to recovery

CRSW certification itself does not constitute clinical licensure.

Activities Generally Outside the CRSW Role

Unless the worker separately holds another applicable professional license, a CRSW generally should not:

Diagnose substance use disorders
Diagnose mental health conditions
Provide psychotherapy
Prescribe medication
Conduct clinical assessments reserved for licensed professionals
Provide medical advice as a licensed healthcare provider
Make involuntary treatment decisions
Independently modify clinical treatment
Represent themselves as a licensed clinician
Make legal determinations

Professional peer recovery work can exist within a clinical organization without becoming clinical treatment.

Recovery Community Organizations

New Hampshire has a substantial statewide network of Recovery Community Organizations, or RCOs.

NH DHHS describes RCOs as peer-led and peer-run agencies supporting people in recovery from substance misuse. (NH Health and Human Services)

State-funded recovery centers are intended to be:

Low barrier
Community based
Free to participants
Open to people pursuing recovery
Supportive of multiple pathways to recovery

(NH Health and Human Services)

What Do New Hampshire RCOs Provide?

New Hampshire RCOs may provide:

Peer recovery coaching
Telephone recovery support
Mutual aid groups
Family support
Harm reduction
System navigation
Advocacy
Recovery activities
Community connection
Resource navigation
Recovery education

(NH Health and Human Services)

The exact service mix differs across organizations.

Peer Recovery Coaching

Peer recovery coaching is a central New Hampshire recovery support service.

State recovery materials identify peer recovery coaching as one of the two core Peer Recovery Support Services expected within Recovery Community Centers, along with continuous recovery monitoring through telephone support. (NH Health and Human Services)

Recovery coaches may help people:

Identify recovery goals
Navigate treatment
Build recovery capital
Connect with mutual support
Address barriers
Connect with housing
Connect with employment
Develop community supports
Build social connection
Explore multiple pathways to recovery

Telephone Recovery Support

Telephone support plays a substantial role in New Hampshire’s recovery infrastructure.

Recovery Community Organizations provide ongoing telephone recovery support as part of maintaining connection and supporting long-term recovery. (NH Health and Human Services)

Programs may use telephone support for:

Check-ins
Encouragement
Goal follow-up
Re-engagement
Community connection
Referral follow-up
Recovery monitoring

Organizations should separately determine when these activities qualify for Medicaid reimbursement versus grant-funded or community-funded programming.

Peer Support Beyond Recovery Centers

New Hampshire recovery peers do not work only in RCOs.

State recovery materials identify peer recovery support in settings such as:

Hospitals
Clinical treatment programs
Drug courts
Community recovery centers
Other referral settings

(NH Health and Human Services)

RCOs may also partner with outside organizations to embed or provide peer recovery workers in other community systems.

Is Peer Support Covered by New Hampshire Medicaid?

Yes.

New Hampshire Medicaid covers multiple forms of peer and recovery support depending on the program.

These include applicable:

SUD recovery support services
Mental health peer services
Youth peer support
Family peer support

The billing and workforce rules are not identical across these services.

Medicaid SUD Recovery Support Services

New Hampshire Medicaid rules explicitly cover Recovery Support Services within the substance use disorder system.

Current Medicaid rules state that qualifying recovery support services may include:

Skill restoration supporting recovery
Crisis support available by telephone
Transportation access assistance
Individual skill development
Psychoeducation
Recovery plan development and revision
Recovery goal development and refinement

(New Hampshire General Court)

These are formal Medicaid services and should be distinguished from all activities occurring within a grant-funded RCO.

Who Can Provide Medicaid SUD Recovery Support?

Current New Hampshire Medicaid rules allow recovery support services to be provided by:

A Certified Recovery Support Worker
A Licensed Alcohol and Drug Counselor
A Master Licensed Alcohol and Drug Counselor
Certain licensed psychotherapists

(New Hampshire General Court)

For peer-specific service delivery, the CRSW is the central workforce credential.

Which Organizations Can Provide Medicaid Recovery Support?

Current rules state that recovery support services may be provided through a Medicaid-enrolled:

Outpatient SUD program
Comprehensive SUD treatment program
Peer recovery program

(New Hampshire General Court)

This is particularly important for New Hampshire recovery organizations.

Being an RCO does not automatically mean every peer service is Medicaid billable.

The organization must separately satisfy the applicable Medicaid provider and program requirements.

Medicaid Supervision

Current New Hampshire Medicaid SUD recovery support rules require the individual delivering recovery support to be supervised by a qualifying practitioner under the applicable Medicaid rules. (New Hampshire General Court)

The rules further state that:

Recovery support is billed by the qualifying program
The supervising practitioner is listed as the rendering provider for billing under the applicable rule

(New Hampshire General Court)

Organizations should carefully configure their documentation and claims workflows around the current New Hampshire Medicaid requirements.

Medicaid SUD Peer Support Coding

New Hampshire Medicaid uses H0038 for qualifying self-help or Peer Support Services.

Available Medicaid materials identify:

H0038

Self-help/peer services per 15 minutes.

H0038 HQ

Self-help/peer services in a group setting per 15 minutes.

(Medicaid Quality)

Organizations should verify:

Current modifiers
Fee schedule
Authorization
Service limits
Provider enrollment
Managed care requirements

before billing.

Mental Health Peer Support and Medicaid

Peer professionals also operate within New Hampshire’s Medicaid community mental health infrastructure.

The New Hampshire Community Mental Health Provider Manual recognizes peer and recovery workforce roles within the broader public mental health system. (NH MMIS)

Mental health Peer Support Specialists may participate in services through:

Community Mental Health Programs
Mobile crisis
Other community mental health services
Integrated behavioral health teams

The precise billing pathway depends on the underlying service rather than on a single universal peer code.

Youth Peer Support

New Hampshire Medicaid recognizes Youth Peer Support in applicable children’s behavioral health programs.

Available Medicaid fee schedule materials identify H0038 with youth-specific modifiers for Youth Peer Support. (NH MMIS)

Youth peer workers may help young people:

Develop self-advocacy
Navigate behavioral health services
Build confidence
Establish goals
Develop community connections
Transition toward adulthood
Build recovery and wellness skills
Strengthen youth voice

Programs should confirm current:

Age criteria
Workforce qualifications
Training
Supervision
Service planning
Medicaid modifiers
Documentation requirements

before billing Youth Peer Support.

Family Peer Support

New Hampshire Medicaid also recognizes Family Peer Support in applicable children’s behavioral health programs.

Available Medicaid fee schedule materials identify H0038 with family-specific modifiers. (NH MMIS)

Family Peer Support may help parents and caregivers:

Navigate behavioral health systems
Advocate for children
Understand services
Connect with community resources
Participate in care planning
Build confidence
Develop natural supports
Learn from another caregiver’s lived experience

Family peer support should remain distinct from family therapy, legal representation, and professional clinical case management.

Mobile Crisis Peer Support

New Hampshire has significantly incorporated peers into its behavioral health crisis system.

State behavioral health planning materials describe New Hampshire Rapid Response mobile crisis teams as multidisciplinary teams that include clinical staff and at least one peer specialist. (NH Health and Human Services)

Peers may support crisis response by:

Building rapport
Providing lived-experience perspective
Reducing fear
Supporting de-escalation
Connecting people with community resources
Supporting follow-up
Helping people remain engaged after crisis
Supporting transitions

State materials describe peers as playing a significant role in community engagement and follow-up after mobile crisis encounters. (NH Health and Human Services)

Rapid Response and Peer-Led Crisis Engagement

New Hampshire’s mobile crisis model demonstrates how peers can participate meaningfully in crisis systems without taking over functions reserved for clinicians.

In some rural portions of New Hampshire, state planning materials have described peers playing especially prominent roles in crisis response, with clinicians brought in when needed. (NH Health and Human Services)

Organizations should nevertheless maintain clear escalation procedures involving:

Suicide risk
Violence risk
Medical emergency
Clinical assessment
Involuntary treatment
Medication
Other issues outside peer scope

Peer Support in Community Mental Health Programs

New Hampshire’s Community Mental Health Programs, or CMHPs, are a major part of the state’s public behavioral health system.

Peer specialists may function as members of treatment teams while retaining their distinct peer role.

Current state mental health rules describe Peer Support Specialists as professionals who:

Enter mutually supportive, non-authoritative relationships
Support wellness and recovery as defined by the participant
Complete required training
Function as members of treatment teams
Advocate for people receiving services
Provide services pursuant to the applicable individual service plan

(New Hampshire General Court)

Mental Health Peer Support vs. CRSW

Area	Mental Health Peer Support Specialist	Certified Recovery Support Worker
Primary focus	Mental health recovery	Substance use recovery
Credentialing structure	NH DHHS certification	State professional certification
Regulatory authority	NH DHHS mental health system	Board of Licensing for Alcohol and Other Drug Use Professionals
Lived experience	Mental health system experience	Substance use recovery experience
Core training	NH Peer Support Specialist certificate program	At least 46 qualifying education hours
Work-hour requirement	Program-specific	500 hours for initial CRSW certification
Exam	Replaced by certificate program for new mental health peers	Required
Typical settings	PSAs, CMHPs, crisis, community mental health	RCOs, SUD programs, hospitals, courts, recovery programs
Medicaid relevance	Yes in applicable mental health services	Yes in qualifying SUD recovery support
Clinical license	No	No

Organizations operating across mental health and SUD systems should not assume that one credential automatically satisfies the other role.

Recovery Community Organization vs. Peer Support Agency

New Hampshire also distinguishes between two types of peer-led organizations.

Area	Recovery Community Organization	Peer Support Agency
Primary focus	Substance use recovery	Mental health recovery
Common abbreviation	RCO	PSA
State connection	NH DHHS recovery system	NH DHHS Bureau of Mental Health Services
Peer workforce	CRSWs and recovery peers	Mental health Peer Support Specialists
Services	Coaching, telephone support, mutual aid, family support, navigation	Peer support, outreach, wellness, advocacy, warmline, respite
Clinical treatment	No	No
Low-barrier community role	Yes	Yes
Lived experience	SUD recovery	Mental health/public system experience

Both models are peer-centered, but they come from different systems and have different workforce and funding structures.

Scope of Practice

New Hampshire peer professionals generally provide nonclinical, relationship-based support.

Depending on the role, appropriate peer activities may include:

Sharing lived experience
Recovery mentoring
Recovery planning
Self-advocacy
Wellness support
Resource navigation
Natural support development
Community connection
Recovery capital development
Treatment engagement
Mutual aid connection
Telephone support
Outreach
Crisis support
Transition support
Peer groups
Family support
Youth support
Harm reduction
Housing and employment navigation

Activities Generally Outside Peer Scope

Unless separately licensed and authorized, peer workers generally should not:

Diagnose behavioral health conditions
Provide psychotherapy
Prescribe medication
Conduct licensed clinical assessments
Make involuntary treatment decisions
Provide medical advice as licensed professionals
Independently change treatment plans
Determine Medicaid eligibility
Represent themselves as clinicians
Provide legal advice

Supervision of Peer Professionals

Supervision should reflect the specific peer pathway.

Mental health peer supervision may address:

Mutuality
Use of lived experience
Recovery orientation
Boundaries
Advocacy
Non-authoritative relationships
Crisis response
Documentation
Staff wellness

CRSW supervision may address:

Recovery coaching
Ethics
Boundaries
Recovery planning
Resource navigation
SUD systems
Documentation
Medicaid requirements
Professional development

Medicaid-funded SUD recovery support also carries separate practitioner supervision requirements. (New Hampshire General Court)

Organizations should distinguish among:

Administrative supervision
Peer practice supervision
Medicaid-required supervision
Clinical consultation

Documentation for New Hampshire Peer Support

Peer documentation should accurately explain what occurred without turning peer relationships into psychotherapy.

A strong peer note may include:

Participant identifier
Date
Start time
End time
Duration
Location
Modality
Peer worker
Peer credential
Recovery or wellness goal
Peer activity
Relevant use of lived experience
Resource navigation
Skills discussed
Natural supports
Participant response
Progress
Follow-up
Connection to service or recovery plan
Required signature

Documentation Should Be

Accurate
Timely
Person-centered
Recovery-oriented
Strengths-based
Respectful
Specific
Relevant
Connected to participant goals
Consistent with peer scope
Consistent with payer requirements when billed

Documentation Should Avoid

Unsupported diagnoses
Clinical interpretations outside peer scope
Stigmatizing language
Generic phrases such as “provided peer support”
Identical copied notes
Unnecessary trauma details
Services that did not occur
Personal opinions presented as clinical facts
Documentation written only to generate reimbursement

Recovery Plans

New Hampshire Medicaid recovery support rules specifically include development and periodic revision of a recovery plan based on information collected during assessment. (New Hampshire General Court)

A recovery plan may identify:

Recovery goals
Strengths
Resources
Natural supports
Services
Skills
Barriers
Next steps
Participant priorities

Peer services should connect meaningfully to the participant’s recovery goals rather than exist as isolated encounters.

Documentation and Billing Are Not the Same Thing

A complete peer note does not automatically make the service Medicaid reimbursable.

Payment may additionally depend on:

Medicaid eligibility
Covered benefit
Provider enrollment
Program type
Worker qualification
CRSW certification where required
Supervision
Recovery plan
Authorization
Medical necessity
Correct H0038 code
Correct modifier
Units
Documentation
Timely filing

Organizations should separately validate:

The service occurred.
The worker was qualified.
The organization was eligible.
The participant qualified.
Documentation accurately describes the service.
The claim satisfies the applicable Medicaid rule.

New Hampshire peer programs may handle sensitive mental health and substance use information.

Applicable requirements may include:

HIPAA
42 CFR Part 2
New Hampshire confidentiality laws
Medicaid requirements
DHHS requirements
Professional certification standards
Employer policies
Consent requirements

Peer workers should receive training addressing:

What information they may access
What should be documented
What can be shared
Participant consent
SUD records
Mental health records
Care-team communication
Youth and family privacy
Text messaging
Email
Telehealth
Social media
Crisis communication
Legal requests

Where Peer Support Is Delivered in New Hampshire

Recovery Community Organizations

RCOs provide community-based SUD recovery support.

Peer Support Agencies

PSAs provide peer-led mental health support, wellness, advocacy, and community programming.

Community Mental Health Programs

Peer specialists work within formal community behavioral health teams.

Mobile Crisis

Peers participate in New Hampshire Rapid Response services.

Hospitals

Recovery peers may help with:

Overdose response
Behavioral health engagement
Treatment connection
Discharge
Recovery planning
Community follow-up

Substance Use Treatment Programs

CRSW professionals may provide qualifying recovery support within outpatient and comprehensive SUD programs.

Drug Courts and Justice Programs

Peer recovery services may support people involved in:

Drug courts
Reentry
Probation
Diversion
Community supervision

Recovery Housing

Peer recovery workers may support people living in recovery residences through recovery planning, community connection, and resource navigation.

Youth Behavioral Health

Youth peer workers may support transition-age participants in applicable Medicaid and behavioral health programs.

Family Programs

Family peers may help caregivers navigate children’s behavioral health services.

Starting a Peer Support Program in New Hampshire

Organizations should begin by determining whether they are building a mental health peer program, SUD recovery program, youth peer program, family peer program, or integrated model.

Step 1: Define the Population

Determine whether services are intended for:

Adults with mental health conditions
People with substance use disorders
People with co-occurring conditions
Youth
Families
People leaving hospitals
People experiencing crisis
People involved with justice systems
People living in recovery housing
Other populations

Step 2: Determine the Appropriate Peer Credential

Determine whether workers need:

New Hampshire Peer Support Specialist certification
CRSW certification
Youth-specific peer qualification
Family-specific peer qualification
Additional specialty training

Step 3: Determine Organizational Structure

Identify whether the organization is operating as a:

Peer Support Agency
Recovery Community Organization
Medicaid peer recovery program
Community Mental Health Program
SUD treatment provider
Hospital
Crisis provider
Other community organization

Step 4: Determine the Funding Model

Potential funding sources include:

New Hampshire Medicaid
NH DHHS contracts
Mental Health Block Grant
Substance Use Prevention, Treatment and Recovery Services Block Grant
Opioid settlement funds
Federal grants
Hospital contracts
Local funding
Philanthropy
Other contracts

Step 5: Establish Credential Tracking

For CRSW workers, track:

46 education hours
500 work hours
Examination
Certification
Credential status
Renewal
Continuing education
Background screening

For mental health peer workers, track:

Certificate program enrollment
Module completion
Certification
Employer training
Professional development
Specialty training

Step 6: Establish Supervision

Determine:

Administrative supervisor
Peer practice supervisor
Medicaid supervising practitioner if applicable
Frequency
Documentation
Crisis escalation
Clinical consultation
Staff wellness

Step 7: Build the Service Workflow

Map:

Referral
Eligibility
Intake
Consent
Peer assignment
Recovery planning
Scheduling
Service delivery
Documentation
Supervision
Follow-up
Outcomes
Billing

Step 8: Establish Role Boundaries

Develop policies covering:

Use of lived experience
Scope of practice
Confidentiality
Dual relationships
Transportation
Gifts
Social media
Communication outside work
Crisis response
Clinical escalation
Staff wellness
Role drift

Step 9: Configure Medicaid Workflows

If Medicaid reimbursement applies, configure:

Member eligibility
Provider enrollment
Service program
CRSW qualification
Supervising practitioner
Recovery plan
H0038
HQ when applicable
Units
Authorization
Documentation
Claims

Step 10: Measure Outcomes

Potential measures include:

Referral-to-contact time
Engagement
Retention
Recovery goals
Recovery capital
Treatment engagement
Community connection
Natural supports
Housing stability
Employment
Self-advocacy
Crisis utilization
Hospital readmission
Participant satisfaction
Peer workforce retention
Documentation timeliness
Supervision completion

Common Challenges for New Hampshire Peer Programs

Two Different Peer Systems

New Hampshire’s mental health Peer Support Specialist pathway and CRSW pathway are separate.

Organizations working across both mental health and substance use recovery need to track workforce qualifications carefully.

Training Does Not Equal CRSW Certification

A recovery coaching course alone does not establish CRSW status.

New Hampshire requires education, practical experience, examination, and state certification.

Medicaid vs. Grant-Funded Peer Support

Many New Hampshire RCO services are grant-funded and intentionally low barrier.

Medicaid recovery support has more specific requirements involving:

Provider enrollment
CRSW qualification
Supervision
Service planning
Documentation
Claims

Programs should avoid applying Medicaid requirements unnecessarily to every community recovery interaction while still meeting them when reimbursement is sought.

Supervision Structure

The person supporting peer practice may not be the same person required for Medicaid billing supervision.

Programs should clearly distinguish these functions.

Documentation Burden

Peer workers are hired for their ability to build relationships based on lived experience.

Poorly designed documentation systems can reduce time available for peer connection and encourage unnecessarily clinical language.

Role Drift

Peers may gradually be assigned:

Generic case management
Transportation
Administrative work
Compliance monitoring
Clinical tasks

Organizations should protect the peer role.

Rural Access

New Hampshire includes rural regions where behavioral health services may be difficult to access.

Peer support can help extend:

Community engagement
Recovery support
Crisis response
Telephone support
Resource navigation

but programs also need infrastructure for travel, mobile documentation, supervision, and communication.

Fragmented Technology

Programs may use separate systems for:

Referral
Intake
Recovery plans
Scheduling
Peer notes
Credential tracking
Supervision
Participant communication
Outcomes
Medicaid claims
Grant reporting

This creates significant administrative burden.

Frequently Asked Questions

What is New Hampshire’s mental health peer credential?

New Hampshire uses a state Peer Support Specialist certification supported by the NH DHHS Peer Support Specialist certificate program. (NH Health and Human Services)

What is New Hampshire’s substance use peer credential?

The Certified Recovery Support Worker, or CRSW. (New Hampshire General Court)

Who regulates CRSW certification?

The New Hampshire Board of Licensing for Alcohol and Other Drug Use Professionals through the Office of Professional Licensure and Certification. (New Hampshire General Court)

How much education does a CRSW need?

Current rules require at least 46 hours. (New Hampshire General Court)

How much experience does a CRSW need?

At least 500 hours of qualifying paid or volunteer recovery support experience. (New Hampshire General Court)

Does a CRSW need a high school diploma?

Yes, or an equivalent credential. (New Hampshire General Court)

Is there a CRSW examination?

Yes. New Hampshire requires a qualifying peer recovery examination. (New Hampshire General Court)

Is a background check required for CRSW certification?

Yes. Current rules include state and federal criminal history review. (New Hampshire General Court)

Can a recovery coach call themselves a CRSW without certification?

No. State law protects the Certified Recovery Support Worker title and CRSW abbreviation. (New Hampshire General Court)

Does New Hampshire have Recovery Community Organizations?

Yes. New Hampshire funds a statewide network of peer-led and peer-run RCOs. (NH Health and Human Services)

What do RCOs provide?

Common services include peer recovery coaching, telephone support, mutual aid, family support, harm reduction, system navigation, and advocacy. (NH Health and Human Services)

Are New Hampshire RCO services free?

State-funded recovery centers are described by NH DHHS as low barrier and no cost to participants. (NH Health and Human Services)

Does New Hampshire have mental health Peer Support Agencies?

Yes.

State rules establish Peer Support Agencies as peer-led organizations for adults with relevant mental health lived experience. (New Hampshire General Court)

What do Peer Support Agencies provide?

Required services include peer support, telephone support, outreach, wellness training, education, individual assistance, and self-advocacy support. (New Hampshire General Court)

Does New Hampshire have peer respite?

Yes. Peer Support Agencies may operate short-term, 24-hour non-medical peer respite programs. (New Hampshire General Court)

Does New Hampshire Medicaid cover SUD peer recovery support?

Yes. Current Medicaid rules cover recovery support through qualifying Medicaid providers. (New Hampshire General Court)

Who can deliver Medicaid SUD Recovery Support Services?

Current rules include CRSWs and certain licensed behavioral health professionals. (New Hampshire General Court)

Can an RCO automatically bill Medicaid because it provides peer recovery coaching?

No.

The organization must satisfy the requirements for a Medicaid-enrolled peer recovery program or another qualifying provider structure.

What is the Medicaid peer code?

H0038 is used for qualifying peer services, including SUD self-help/peer services in current Medicaid materials. (Medicaid Quality)

Can group peer support be billed?

H0038 HQ appears in New Hampshire Medicaid materials for group self-help/peer services. Organizations should verify the current program requirements before billing. (Medicaid Quality)

Does New Hampshire Medicaid cover Youth Peer Support?

Yes, within applicable programs. Medicaid fee schedule materials identify youth-specific H0038 billing. (NH MMIS)

Does New Hampshire Medicaid cover Family Peer Support?

Yes, within applicable children’s behavioral health programs. (NH MMIS)

Do peers work on mobile crisis teams?

Yes. New Hampshire’s Rapid Response system incorporates peer specialists into mobile crisis teams. (NH Health and Human Services)

Is Intentional Peer Support required for new mental health Peer Support Specialists?

No. Current NH DHHS guidance states that IPS is not a required component of the newer state Peer Support Specialist certificate program. (NH Health and Human Services)

Are Peer Support Specialists clinicians?

No.

Peer support is grounded in lived experience, mutuality, recovery, and nonclinical relationships.

Official New Hampshire Peer Support Resources

New Hampshire Peer Support Specialist Certificate Program

Official NH DHHS resource explaining the state’s standardized mental health Peer Support Specialist certification curriculum, nine required modules, certification process, ongoing professional development, and relationship to Intentional Peer Support.