Pennsylvania Peer Support & Medicaid Guide

Pennsylvania has a well-developed peer support and recovery workforce spanning mental health, substance use recovery, family recovery, Medicaid-funded behavioral health services, community recovery organizations, hospitals, treatment providers, justice programs, and other community settings.

The state has several important peer and recovery credentials administered by the Pennsylvania Certification Board, commonly known as PCB:

Certified Peer Specialist, or CPS, primarily centered on personal lived experience with mental health recovery
Certified Recovery Specialist, or CRS, centered on personal lived experience with substance use disorder recovery
Certified Family Recovery Specialist, or CFRS, centered on lived experience being affected by a family member or loved one’s substance use disorder
Certified Recovery Specialist Supervisor, or CRSS, for professionals supervising CRS and CFRS workers

Pennsylvania Medicaid formally covers qualifying Peer Support Services, or PSS. The current statewide standards are established through OMHSAS Bulletin 24-05, effective December 20, 2024, and its accompanying Provider Handbook. The 2024 update revised Certified Peer Specialist and supervisor qualifications and formally permits PSS through telehealth, including audio-only delivery.

Pennsylvania Peer Support Quick Facts

Category	Pennsylvania overview
State Medicaid program	Pennsylvania Medical Assistance
Behavioral health authority	Office of Mental Health and Substance Abuse Services
Abbreviation	OMHSAS
Mental health peer credential	Certified Peer Specialist
Abbreviation	CPS
Substance use recovery credential	Certified Recovery Specialist
Abbreviation	CRS
Family recovery credential	Certified Family Recovery Specialist
Abbreviation	CFRS
Recovery supervisor credential	Certified Recovery Specialist Supervisor
Abbreviation	CRSS
Credentialing organization	Pennsylvania Certification Board
CPS training	75 hours
CRS training	78 hours
CPS examination	Required
CRS examination	Required
CRS lived recovery	More than 18 continuous months
CPS certification period	2 years
CPS continuing education	36 hours per 2 years
CRS continuing education	30 hours per certification cycle
Medicaid peer support	Yes
Medicaid CPS certification	Required for billable PSS
Telehealth PSS	Permitted
Audio-only PSS	Permitted
Youth PSS	Permitted for qualifying youth
Last reviewed	August 2026

What Is Peer Support in Pennsylvania?

Pennsylvania describes Peer Support Services as self-directed, person-centered services with a recovery focus.

Peer Support Services facilitate the development of recovery skills and may include:

Individual advocacy
Education
Development of natural supports
Support for work and other meaningful activities
Crisis management support
Skills training
Effective use of available services and resources

Pennsylvania began developing its formal Peer Specialist infrastructure in the early 2000s. CMS approved Pennsylvania’s Medicaid State Plan Amendment adding Peer Support Services as a rehabilitative service in 2007.

The state’s Medicaid PSS model is specifically designed around individual choice and active involvement in recovery.

Pennsylvania’s Peer Credential Structure

Pennsylvania’s peer workforce is somewhat unusual because mental health and substance use recovery have developed through distinct credential pathways.

The major credentials are:

Certified Peer Specialist

Primarily associated with personal lived experience with a mental health disorder.

Certified Recovery Specialist

Primarily associated with personal lived experience with substance use disorder recovery.

Certified Family Recovery Specialist

Associated with personal lived experience being directly affected by a family member or loved one’s substance use disorder.

These credentials should not be treated as interchangeable.

Certified Peer Specialist

The Certified Peer Specialist, or CPS, is Pennsylvania’s primary formal mental health peer credential.

PCB describes the CPS credential as intended for individuals with personal lived experience with a mental health disorder who use their recovery experience to provide peer support to others.

Pennsylvania requires formal PCB certification for a CPS providing Medicaid-billable Peer Support Services.

CPS Lived Experience

Personal lived experience is foundational to CPS certification.

Applicants must have personal lived experience with a mental health disorder and provide a written statement describing:

Their pathway to recovery and wellness
How they achieved recovery or wellness
How they maintain it
Why they are ready to support people with similar experiences

PCB currently requires this statement to be at least one page.

CPS Training

Pennsylvania requires 75 hours of mandatory Peer Specialist training.

PCB currently recognizes authorized training providers rather than allowing any generic peer training to satisfy the requirement.

This is important for organizations recruiting peers who received peer training elsewhere.

Completing a peer support course does not necessarily mean the training qualifies toward Pennsylvania CPS certification.

CPS Examination

After PCB approves the certification application, a CPS applicant must pass the Pennsylvania Certification Board’s Certified Peer Specialist examination.

PCB currently identifies the CPS examination as:

50 questions
Multiple choice
1.5 hours
Available through approved testing formats

Applicants become eligible to test only after PCB determines that the certification requirements have been properly documented.

CPS Certification Period

Pennsylvania CPS certification is valid for two years.

Peers should complete recertification before the end of the two-year certification period to avoid a lapse.

Organizations employing CPS professionals should therefore track credential expiration centrally rather than relying entirely on individual employees.

CPS Continuing Education

Pennsylvania currently requires 36 hours of continuing education every two years for CPS recertification.

PCB specifies:

24 hours specific to peer support and/or recovery practices
3 hours of ethics
9 additional hours selected by the professional

This makes category-level continuing education tracking useful for Pennsylvania peer organizations.

Certified Recovery Specialist

The Certified Recovery Specialist, or CRS, is Pennsylvania’s primary credential for people using their personal substance use recovery experience professionally.

PCB describes a CRS as a:

Role model
Mentor
Advocate
Motivator

rather than a sponsor, therapist, or case manager.

This distinction is important for preserving peer role fidelity.

CRS Lived Experience

CRS applicants must have personal lived experience with their own substance use disorder recovery.

PCB currently requires more than 18 months of continuous personal lived recovery experience.

This requirement also applies when entering the standardized CRS training.

CRS Education Requirement

Applicants must have at least:

High school diploma
GED

A college degree is not required.

CRS Training

Pennsylvania currently requires 78 hours of mandatory standardized Recovery Specialist training for CRS certification.

The curriculum addresses professional recovery support rather than clinical treatment.

Recovery Specialists are expected to understand that their role is rooted in lived experience and includes:

Mentoring
Advocacy
Motivation
Recovery support
Reducing stigma
Identifying barriers
Building natural supports
Strengthening community connection

CRS Recovery Statement

Applicants must submit a written statement of lived experience.

PCB currently requires a minimum 1,000-word essay describing:

Personal recovery experience
History of sustained recovery

CRS Examination

After the application is approved, applicants must pass the PCB Certified Recovery Specialist examination.

The current CRS exam contains:

50 questions
Multiple-choice format
1.5-hour testing period

CRS Continuing Education

PCB currently requires 30 hours of continuing education for CRS recertification.

Those hours include:

6 hours of ethics
3 hours of confidentiality
Remaining hours relevant to recovery support services

Certified Family Recovery Specialist

Pennsylvania also recognizes the Certified Family Recovery Specialist, or CFRS.

This credential is designed for adults who have been directly affected by a family member or loved one’s substance use disorder.

The CFRS uses that lived experience to help other families navigate recovery.

Family recovery support may include:

Education
Advocacy
Family recovery planning
Resource navigation
Boundary development
Self-care
Understanding addiction
Recovery system navigation
Community resources
Family wellness
Hope and encouragement

CFRS Lived Experience

Unlike a CRS, the CFRS does not derive their peer expertise primarily from their own substance use recovery.

The defining lived experience is being directly impacted by a:

Family member
Loved one

with a substance use disorder.

This distinction is important when matching peer credentials to participant and family needs.

CFRS Education

PCB requires at least:

High school diploma
GED

for CFRS certification.

CFRS Lived Experience Statement

Applicants must submit a statement describing the impact their family member or loved one’s substance use disorder had on them.

PCB currently requires a minimum 1,000-word essay.

CFRS References

CFRS applicants must submit three letters of reference or character.

Organizations helping workers pursue certification should therefore incorporate reference collection into the credentialing workflow.

CFRS Continuing Education

CFRS recertification currently requires 30 hours relevant to family recovery support, including:

6 hours of ethics
3 hours of confidentiality

Certified Recovery Specialist Supervisor

Pennsylvania has a dedicated credential for professionals supervising recovery specialists.

The Certified Recovery Specialist Supervisor, or CRSS, is designed for individuals supervising:

CRS professionals
CFRS professionals

CRSS Requirements

Requirements differ depending on whether the supervisor already holds CRS or CFRS certification.

For a current CRS or CFRS, PCB currently requires:

Two years of full-time or 4,000 hours of part-time recovery support experience
One year of direct supervision experience
25 hours of on-the-job supervision in CRSS domains
30 hours of education specific to CRSS domains

Different training requirements apply to applicants who are not already CRS or CFRS professionals.

This is particularly relevant for organizations building larger recovery support teams.

Mental Health Peer Support

Pennsylvania’s Medicaid Peer Support Services infrastructure historically centers strongly on mental health recovery.

CPS professionals may help individuals:

Identify strengths
Develop recovery goals
Build natural supports
Develop self-advocacy
Navigate behavioral health systems
Engage with meaningful activities
Develop skills
Navigate crises
Connect with community resources
Strengthen community integration

Pennsylvania describes these services as self-directed and person-centered.

Substance Use Recovery Support

CRS professionals work across Pennsylvania’s substance use recovery system.

Recovery support may include:

Recovery coaching
Recovery planning
Treatment navigation
MOUD support
Mutual-aid connection
Recovery capital development
Housing navigation
Employment resources
Community connection
Harm reduction
Advocacy
Long-term recovery support

The role should remain grounded in lived experience rather than becoming generic clinical case management.

Family Recovery Support

CFRS professionals support families affected by substance use disorders.

Family recovery support recognizes that addiction can affect:

Parents
Children
Partners
Siblings
Caregivers
Other loved ones

The family’s own recovery needs may continue regardless of whether the person with the substance use disorder is currently engaged in treatment.

Youth Peer Support

Pennsylvania permits Medicaid Peer Support Services for qualifying youth.

The state previously expanded its standards to allow approved PSS provider agencies to serve qualifying youth who are 14 years old but under 18.

Youth peer programs should carefully address:

Developmental appropriateness
Consent
Family involvement
Youth voice
Confidentiality
Peer matching
Documentation
Crisis escalation
School and community systems

Peer Support for Priority Populations

Pennsylvania has developed peer continuing education and specialization opportunities for priority populations including:

Older adults
Forensic populations
Veterans
Youth
People with mental health and intellectual disability needs
Supported employment participants
People receiving crisis services

This makes Pennsylvania’s peer workforce broader than a single generic CPS role.

Pennsylvania Medicaid Peer Support Services

Pennsylvania Medical Assistance covers qualifying Peer Support Services.

Pennsylvania’s PSS standards apply to providers enrolled or seeking enrollment through:

Medical Assistance Fee-for-Service
Behavioral Health HealthChoices

The program pays for specific medically necessary peer support services delivered to eligible individuals by properly enrolled PSS provider agencies.

Behavioral Health HealthChoices

Pennsylvania’s behavioral health Medicaid system relies heavily on Behavioral Health HealthChoices.

This means organizations should not assume that statewide Medicaid coverage produces one identical operational workflow everywhere.

Peer providers may need to account for:

County
Primary contractor
Behavioral Health Managed Care Organization
Network participation
Authorization
Provider enrollment
Billing
Documentation requirements

The current PSS bulletin applies to PSS providers, Primary Contractors, and Behavioral Health Managed Care Organizations.

Medicaid Certification Requirement

Formal CPS certification through PCB is necessary for Certified Peer Specialists delivering Medicaid-billable Peer Support Services.

This creates an important distinction between:

Someone providing informal peer support

and

A Certified Peer Specialist providing Pennsylvania Medicaid Peer Support Services.

Organizations should validate staff credentials before assigning Medicaid-billable services.

PSS Provider Requirements

Pennsylvania Medicaid PSS reimbursement involves more than hiring a Certified Peer Specialist.

Provider agencies must satisfy applicable:

OMHSAS licensing requirements
Medical Assistance enrollment
Service description requirements
Staffing standards
Supervision requirements
Documentation standards
HealthChoices requirements

Pennsylvania DHS maintains specific resources for organizations developing Medicaid-funded PSS programs, including enrollment checklists and guidance for writing PSS service descriptions.

Current Pennsylvania PSS Standards

The current major statewide standard is:

OMHSAS Bulletin 24-05: Peer Support Services

effective:

December 20, 2024

The bulletin:

Revised CPS qualifications and requirements
Revised CPS supervisor qualifications and requirements
Permitted Peer Support Services through telehealth
Permitted audio-only Peer Support Services
Issued revised Provider Handbook pages

OMHSAS subsequently issued a detailed FAQ in 2025 to support implementation of the revised requirements.

Telehealth Peer Support

Pennsylvania explicitly permits Medicaid Peer Support Services through telehealth technology under current OMHSAS standards.

Organizations providing virtual PSS should still verify applicable requirements involving:

Participant appropriateness
Privacy
Documentation
Technology
Location
HealthChoices policies
Billing

Audio-Only Peer Support

Current OMHSAS standards also permit audio-only Peer Support Services.

This is particularly relevant for:

Rural participants
People without reliable broadband
Participants without smartphones
People experiencing transportation barriers
Individuals who prefer telephone engagement

Organizations should accurately document modality when services are delivered by telephone.

In-Person Peer Support

In-person peer support remains important across Pennsylvania.

Services may occur in applicable:

Behavioral health settings
Community locations
Recovery programs
Participant environments
Hospitals
Treatment programs
Community organizations

subject to program and payer requirements.

Peer Support and ACT

Pennsylvania’s Assertive Community Treatment model includes a designated Peer Specialist as part of the multidisciplinary ACT team.

ACT teams may also include professionals such as:

Psychiatrist
Registered nurses
Mental health professionals
Mental health workers
Housing Specialist
Substance Abuse Specialist

The peer contributes lived-experience expertise while remaining part of a broader multidisciplinary service model.

Scope of Peer Support

Depending on credential and program, Pennsylvania peers may support participants through:

Sharing relevant lived experience
Recovery mentoring
Recovery planning
Wellness planning
Self-advocacy
Individual advocacy
System navigation
Community integration
Natural support development
Resource navigation
Skills development
Treatment engagement
Employment support
Education support
Crisis support
Recovery capital development
Family recovery
Community connection

Activities Generally Outside Peer Scope

Unless separately qualified and authorized under another professional role, peer professionals generally should not:

Diagnose mental illness
Diagnose substance use disorders
Conduct psychotherapy
Provide licensed counseling
Prescribe medication
Provide medical advice
Conduct clinical assessments requiring licensure
Independently make involuntary treatment decisions
Independently modify clinical treatment
Represent themselves as licensed clinicians
Determine Medicaid eligibility
Provide legal advice

PCB specifically distinguishes the CRS from a therapist or case manager.

Peer Supervision

Pennsylvania organizations should provide supervision that protects the distinct peer role.

Peer supervision may address:

Use of lived experience
Recovery orientation
Ethics
Confidentiality
Boundaries
Role fidelity
Documentation
Advocacy
Recovery planning
Difficult interactions
Self-care
Professional development

Pennsylvania maintains specific Medicaid supervision requirements for PSS, while PCB separately maintains the CRSS credential for professionals supervising CRS and CFRS workers.

Organizations should not assume that supervision requirements for CPS, CRS, and CFRS roles are identical.

Documentation for Pennsylvania Peer Support

Pennsylvania DHS provides sample documentation resources specifically for Medicaid Peer Support Services, including:

Strengths-Based Assessment
Individual Service Plan
Progress Note
Discharge Plan

A strong peer support record may include:

Participant identifier
Date
Start and end time
Duration
Location or modality
Peer worker
Credential
Recovery goal
Service-plan goal
Peer intervention
Relevant use of lived experience
Skills addressed
Advocacy
Natural supports
Community resources
Participant response
Progress
Barriers
Follow-up
Signature or attestation

Strengths-Based Assessment

Pennsylvania’s formal Medicaid PSS infrastructure includes a Strengths-Based Assessment.

A strengths-based approach should focus on areas such as:

Existing abilities
Personal strengths
Natural supports
Community resources
Recovery assets
Participant preferences
Aspirations
Goals

rather than documenting only deficits and symptoms.

Individual Service Plan

Pennsylvania Medicaid PSS also uses an Individual Service Plan framework.

Peer services should connect to the individual’s recovery goals rather than operating as unstructured contacts.

The participant should remain actively involved in identifying and shaping those goals.

Progress Notes

Peer progress notes should demonstrate:

What happened
Why the peer interaction occurred
Which recovery goal was addressed
What the CPS did
How the participant engaged
What progress or barriers emerged
What happens next

A note that simply states “provided peer support” does not meaningfully describe the service.

Documentation Should Be

Accurate
Timely
Person-centered
Self-directed
Recovery-oriented
Strengths-based
Specific
Respectful
Relevant
Consistent with peer scope
Connected to participant goals

Documentation Should Avoid

Unsupported diagnoses
Clinical interpretation outside peer scope
Stigmatizing terminology
Generic service descriptions
Copy-and-paste notes
Unnecessary sensitive information
Services that did not occur
Personal opinions presented as clinical facts
Documentation created solely to maximize reimbursement

Documentation and Billing Are Not the Same Thing

A completed peer note does not automatically establish Medicaid reimbursement.

Payment may additionally depend on:

Medical Assistance eligibility
Behavioral Health HealthChoices enrollment
Medical necessity
Provider licensing
Provider enrollment
CPS certification
Service eligibility
Individual Service Plan
Authorization
Correct billing code
Units
Modifiers
Supervision
Documentation
Timely filing
BH-MCO requirements

Organizations should validate each requirement separately.

Confidentiality

Peer workers may handle highly sensitive:

Mental health information
Substance use information
Family information
Recovery information
Youth information

Applicable requirements may include:

HIPAA
42 CFR Part 2
Pennsylvania law
OMHSAS requirements
Medical Assistance requirements
HealthChoices requirements
Organizational policy
Participant consent

PCB’s CRS and CFRS recertification requirements specifically include continuing education in confidentiality.

Starting a Peer Support Program in Pennsylvania

Step 1: Define the Population

Determine whether the organization primarily serves:

Adults with mental health conditions
People with substance use disorders
Families affected by addiction
Youth
Older adults
Veterans
Justice-involved populations
People receiving ACT
Other behavioral health populations

Step 2: Determine the Credential

Identify whether staff need:

CPS
CRS
CFRS
CRSS
Multiple credentials where applicable

Step 3: Determine Whether Medicaid PSS Applies

Determine whether services will be funded through:

Medical Assistance Fee-for-Service
Behavioral Health HealthChoices
Grants
County funding
Opioid settlement funding
Hospital contracts
State funding
Private contracts
Other recovery funding

Step 4: Establish Provider Compliance

For Medicaid PSS, verify:

OMHSAS licensing
Medical Assistance enrollment
Service description
Staffing
CPS qualifications
Supervision
HealthChoices participation
Documentation
Billing

Step 5: Build Credential Tracking

For CPS workers, track:

Approved 75-hour training
Lived-experience statement
Application
Examination
PCB certification
Expiration
36 CE hours
Peer/recovery CE
Ethics CE
Recertification

For CRS workers, track:

18+ months continuous recovery
High school diploma/GED
78-hour training
1,000-word recovery statement
Examination
PCB certification
CE
Ethics
Confidentiality
Recertification

For CFRS workers, track applicable:

Family lived experience
Education
Training
1,000-word statement
References
Certification
Continuing education
Ethics
Confidentiality
Recertification

Step 6: Establish Supervision

Determine:

Peer supervisor
Recovery specialist supervisor
Administrative supervisor
Clinical consultant
Required qualifications
Frequency
Documentation
Crisis escalation
Staff wellness

Step 7: Build the Service Workflow

Map:

Referral
Eligibility
Intake
Strengths-Based Assessment
Individual Service Plan
Peer assignment
Scheduling
Service delivery
Progress note
Supervision
Follow-up
Outcomes
Discharge
Billing

Step 8: Configure Telehealth

If virtual services are provided, systems should distinguish:

In-person
Video
Audio-only

and maintain appropriate documentation and billing information.

Step 9: Establish Role Boundaries

Develop policies covering:

Use of lived experience
CPS vs. CRS vs. CFRS roles
Peer vs. clinical roles
Confidentiality
Dual relationships
Transportation
Gifts
Social media
Communication outside work
Crisis escalation
Staff wellness
Role drift

Step 10: Measure Outcomes

Potential outcomes include:

Engagement
Recovery goal progress
Recovery capital
Treatment engagement
Self-advocacy
Natural supports
Community integration
Housing
Employment
Family recovery
Crisis utilization
Hospitalization
Participant satisfaction
Peer workforce retention
Documentation timeliness
Credential compliance

Common Challenges for Pennsylvania Peer Programs

CPS vs. CRS

One of Pennsylvania’s biggest operational distinctions is between:

CPS: mental health lived experience

and

CRS: substance use recovery lived experience.

Organizations serving both populations should avoid treating these credentials as interchangeable.

CPS vs. CRS Medicaid Requirements

Pennsylvania’s formal Medicaid Peer Support Services benefit has its own OMHSAS provider and CPS standards.

An organization employing a CRS should not assume that CRS certification automatically satisfies every requirement for Medicaid PSS.

Behavioral Health HealthChoices

Pennsylvania’s county-based behavioral health managed care structure adds operational complexity.

Organizations working across counties may encounter different:

BH-MCOs
Networks
Authorization workflows
Contracts
Claim processes

Credential Tracking

Organizations may employ CPS, CRS, CFRS, and CRSS professionals simultaneously.

Each credential has different:

Lived-experience requirements
Training
Examination
Continuing education
Renewal rules

Telehealth Modality

Because Pennsylvania now permits both video and audio-only PSS, documentation systems should capture service modality accurately.

Youth Peer Services

Youth peer support requires workflows capable of handling:

Youth participants
Guardians
Consent
Confidentiality
Youth voice
Family involvement

rather than simply adapting an adult peer workflow.

Documentation Burden

Medicaid PSS includes structured assessment, service planning, progress documentation, and discharge requirements.

Organizations need enough structure for compliance without turning peer work into clinical documentation.

Role Drift

Peers may gradually become responsible for:

Generic case management
Transportation
Administrative tasks
Compliance monitoring
Clinical work

Organizations should preserve the distinct lived-experience role.

Frequently Asked Questions

What is Pennsylvania’s mental health peer credential?

The Certified Peer Specialist, or CPS.

What is Pennsylvania’s substance use recovery credential?

The Certified Recovery Specialist, or CRS.

Does Pennsylvania have a family recovery credential?

Yes. The Certified Family Recovery Specialist, or CFRS.

Who administers these credentials?

The Pennsylvania Certification Board.

How much training does a CPS need?

75 hours of approved Peer Specialist training.

How much training does a CRS need?

78 hours of mandatory standardized Recovery Specialist training.

Does a CPS need an examination?

Yes.

Does a CRS need an examination?

Yes.

How much lived recovery does a CRS need?

More than 18 continuous months of personal substance use recovery experience.

How often does CPS certification renew?

Every two years.

How much continuing education does a CPS need?

36 hours every two years, including:

24 hours of peer support and/or recovery education
3 hours of ethics
9 additional hours

How much continuing education does a CRS need?

30 hours, including:

6 hours of ethics
3 hours of confidentiality

Does Pennsylvania Medicaid cover Peer Support Services?

Yes.

Pennsylvania Medical Assistance covers qualifying PSS through approved provider agencies.

Does a peer need CPS certification for Medicaid PSS?

For Medicaid-billable Certified Peer Specialist services under Pennsylvania’s formal PSS standards, formal CPS certification is required.

Does Pennsylvania allow telehealth PSS?

Yes.

Does Pennsylvania allow audio-only PSS?

Yes.

Can youth receive Medicaid Peer Support Services?

Yes, when the applicable youth eligibility and provider requirements are satisfied.

Are CPS and CRS credentials interchangeable?

No.

CPS is primarily a mental health peer credential, while CRS is a substance use recovery credential.

Can a CRS provide therapy?

No.

CRS certification is a recovery support credential, not a clinical license.

Can a CPS provide psychotherapy?

No.

CPS certification itself does not authorize psychotherapy.

Are peer professionals clinicians?

No.

Peer credentials themselves do not constitute professional clinical licensure.

Official Pennsylvania Peer Support Resources

Pennsylvania Peer Support Services

Official Pennsylvania DHS resource covering Medicaid Peer Support Services, statewide standards, history, provider resources, youth PSS, training, and implementation.