South Carolina Peer Support & Medicaid Guide

South Carolina has an established peer support workforce spanning substance use recovery, mental health, behavioral health treatment, community recovery organizations, recovery community centers, Medicaid-funded behavioral health services, hospitals, justice programs, outreach, and other community settings.

The state’s primary professional peer credential is the Certified Peer Support Specialist, commonly abbreviated CPSS.

South Carolina uses peer specialists as people with lived recovery experience who help others remove barriers to recovery, identify multiple pathways to recovery, access resources, strengthen self-efficacy, and maintain wellness.

For the substance use recovery pathway, current state-listed CPSS trainings require participants to have at least a high school diploma or GED and generally require at least two years in recovery from a substance use disorder. Approved training programs provide 46 hours of CPSS education. (BHDD)

South Carolina Medicaid also formally reimburses qualifying Peer Support Services, or PSS, using procedure code H0038. (SCDHHS)

South Carolina Peer Support Quick Facts

Category	South Carolina overview
State Medicaid program	Healthy Connections Medicaid
Medicaid agency	South Carolina Department of Health and Human Services
Abbreviation	SCDHHS
State behavioral health agency	Department of Behavioral Health and Developmental Disabilities
Abbreviation	BHDD
Primary peer credential	Certified Peer Support Specialist
Abbreviation	CPSS
Education	High school diploma/GED or higher
SUD recovery requirement	Minimum 2 years
CPSS training	46 hours
Certification test	Required through applicable training/certification pathway
Medicaid peer support	Yes
Medicaid service	Peer Support Services
Medicaid code	H0038
Individual PSS	H0038
Group PSS	H0038 HQ
Telehealth modifier	GT where applicable
Medicaid individual rate	$14.88 per unit on current RBHS fee schedule
Medicaid group rate	$2.61 per unit on current RBHS fee schedule
Last reviewed	August 2026

What Is Peer Support in South Carolina?

South Carolina’s peer support model is grounded in lived experience.

A Certified Peer Support Specialist uses their own recovery experience to support people seeking or maintaining recovery.

Current state-listed training materials describe a CPSS as someone who promotes recovery by:

Removing barriers and obstacles
Serving as a personal guide
Mentoring people seeking recovery
Mentoring people maintaining recovery
Connecting people with resources
Supporting multiple pathways to recovery
Encouraging wellness
Building recovery relationships

(BHDD)

Peer support is not intended to replace clinical treatment.

The value of the peer role comes from combining lived experience with formal training, ethics, recovery-support skills, and knowledge of community resources.

Certified Peer Support Specialist

The Certified Peer Support Specialist, or CPSS, is South Carolina’s primary professional peer designation.

CPSS professionals may work in:

Behavioral health organizations
Substance use treatment programs
Recovery community organizations
Community-based organizations
Mental health programs
Hospitals
Recovery centers
Justice programs
Outreach programs
Medicaid-funded programs

The exact qualification and certification pathway may differ depending on the system and population in which the peer works.

Organizations should therefore verify the requirements applicable to their specific:

Behavioral health authority
Employer
Medicaid program
Contract
Population
Funding source

Substance Use CPSS

South Carolina has a particularly developed substance use recovery peer workforce.

Current state-listed CPSS training programs describe the role as supporting people who are:

Seeking recovery
Entering recovery
Maintaining recovery

from substance use disorders. (BHDD)

Substance use peer services may include:

Recovery mentoring
Recovery coaching
Treatment navigation
Recovery planning
Community connection
Resource navigation
Mutual-aid connection
Recovery capital development
Advocacy
Harm reduction support
MOUD support
Employment resources
Housing resources
Transportation resources
Wellness support

Lived Experience Requirement

Lived recovery experience is fundamental to South Carolina’s substance use CPSS pathway.

Current state-listed CPSS trainings require applicants to have been in recovery for a minimum of two years from a substance use disorder involving alcohol and/or other drugs. (BHDD)

Organizations should document the applicable eligibility requirement during credential onboarding without unnecessarily collecting detailed personal recovery information.

Education Requirement

Current South Carolina substance use CPSS training prerequisites include:

High school diploma
GED
Or higher education

(BHDD)

A college degree is not required for the basic CPSS pathway.

CPSS Training

South Carolina’s substance use CPSS curriculum consists of 46 hours of training.

Multiple state-listed providers currently offer 46-hour CPSS training programs, including programs delivered through organizations such as:

ACCESS FAVOR
FAVOR Lowcountry
CARPS SC

Current 2026 state listings consistently identify these programs as providing 46 hours toward Peer Support Specialist certification. (BHDD)

What CPSS Training Covers

Current South Carolina CPSS training objectives include:

Roles and functions of a CPSS
Relationship-building skills
Co-occurring disorders
Medication-assisted recovery
Stages of change
Ethical issues
Wellness planning
Documentation

(BHDD)

This combination reflects the dual purpose of formal peer training.

Peers learn professional service-delivery skills while maintaining the lived-experience and relationship-based foundation of the role.

Multiple Training Providers

South Carolina does not rely on only one organization to deliver every CPSS training.

Current 2026 state listings include training offered through several organizations.

For example, ACCESS FAVOR provides a 46-hour training for people seeking CPSS certification. (BHDD)

CARPS SC also provides a 46-hour CPSS training program. (BHDD)

FAVOR Lowcountry offers a hybrid 46-hour CPSS program combining in-person and virtual instruction. (BHDD)

Organizations should verify that a particular training is currently recognized for the certification pathway being pursued.

Certification Testing

Current state-listed South Carolina CPSS programs require completion of the full training and applicable certification testing.

For example, current CARPS SC materials state that participants receive 46 hours toward certification when all sessions are attended and the certification test is passed. (BHDD)

Organizations should verify the current testing and certification procedures with the relevant certifying organization before relying on older requirements.

How to Become a South Carolina CPSS

For the substance use recovery pathway, the general process includes:

Step 1: Meet the Education Requirement

Have at least:

High school diploma
GED
Or higher education

Step 2: Meet the Recovery Requirement

Have at least two years of qualifying recovery from alcohol and/or other substance use.

Step 3: Apply for CPSS Training

Complete the required application process through an approved or recognized training provider.

Step 4: Complete CPSS Training

Complete all required hours of the 46-hour training.

Step 5: Complete Required Testing

Pass the applicable certification examination or training test.

Step 6: Maintain the Credential

Complete applicable continuing education and renewal requirements.

Because South Carolina’s peer workforce operates across multiple behavioral health systems, applicants should confirm the requirements associated with their intended employer and service setting.

Recovery Orientation

South Carolina’s CPSS model recognizes that recovery does not have one universal pathway.

Current state-listed training emphasizes directing participants toward multiple pathways to recovery. (BHDD)

Peer specialists should therefore support participant choice rather than requiring everyone to follow the peer’s own recovery pathway.

Possible recovery pathways may involve:

Treatment
Medication
Mutual aid
Recovery community organizations
Faith communities
Harm reduction
Recovery housing
Natural supports
Individual recovery practices
Other community supports

Medication-Assisted Recovery

Current South Carolina CPSS training explicitly includes education on medication-assisted recovery. (BHDD)

This is an important component of contemporary peer practice.

A CPSS should support participant autonomy around medications and treatment rather than imposing personal beliefs about what constitutes legitimate recovery.

Co-Occurring Disorders

South Carolina CPSS training also addresses co-occurring disorders. (BHDD)

Peers may therefore work with individuals experiencing both:

Substance use disorders
Mental health conditions

Organizations should still ensure that peer specialists remain within the peer role and do not independently diagnose or clinically treat either condition.

Stages of Change

South Carolina’s current CPSS curriculum includes education on the stages of change and their applications. (BHDD)

This can help peers work with people at different stages of:

Considering change
Preparing for change
Entering recovery
Maintaining recovery
Re-engaging after recurrence of use

Peer support does not require a participant to already be abstinent or identify as “in recovery” before meaningful engagement can begin.

Ethics

Ethics are incorporated directly into South Carolina CPSS training.

Current training objectives specifically include addressing ethical issues related to professional peer support. (BHDD)

Important peer ethics topics may include:

Confidentiality
Boundaries
Dual relationships
Appropriate self-disclosure
Participant autonomy
Conflicts of interest
Gifts
Social media
Transportation
Professional conduct
Role clarity

Wellness Planning

Current South Carolina CPSS training also includes wellness planning. (BHDD)

This reflects the broader recovery orientation of the role.

Peer specialists may help participants identify:

Strengths
Goals
Recovery supports
Wellness practices
Warning signs
Community resources
Natural supports
Strategies for maintaining recovery

Documentation Training

Documentation is explicitly included in South Carolina’s current 46-hour CPSS training curriculum. (BHDD)

This is particularly important when services are delivered through:

Medicaid
Behavioral health providers
Treatment programs
State contracts
Grant-funded programs

Peer documentation should accurately describe the service without turning peer specialists into clinicians.

South Carolina Medicaid Peer Support

South Carolina Healthy Connections Medicaid reimburses qualifying Peer Support Services.

The current South Carolina Rehabilitative Behavioral Health Services fee schedule includes Peer Support Services under:

H0038

for individual and group peer support. (SCDHHS)

This creates an important distinction between:

Community peer support

and

Medicaid-billable Peer Support Services.

Not every valuable peer interaction automatically qualifies for Medicaid reimbursement.

Medicaid Individual Peer Support

South Carolina’s current RBHS fee schedule identifies:

H0038

for individual Peer Support Services delivered by a CPSS. (SCDHHS)

The fee schedule also recognizes the GT modifier for qualifying telehealth delivery, priced according to the applicable individual service rate. (SCDHHS)

Medicaid Group Peer Support

South Carolina Medicaid also reimburses qualifying group Peer Support Services.

The current RBHS fee schedule identifies:

H0038 HQ

for group Peer Support Services delivered by a CPSS. (SCDHHS)

Organizations should clearly distinguish between individual and group encounters in their documentation and claims workflows.

Current Medicaid Peer Support Rates

The current South Carolina RBHS fee schedule, effective December 1, 2025, identifies:

Service	Code	Current published rate
Individual Peer Support	H0038	$14.88 per unit
Individual Peer Support via qualifying telehealth	H0038 GT	Priced as individual PSS
Group Peer Support	H0038 HQ	$2.61 per unit

(SCDHHS)

Providers should always verify the current fee schedule before relying on these amounts for financial planning or claims submission.

Important Medicaid Rate Clarification

SCDHHS issued a correction to its December 2025 behavioral health rate update involving H0038.

The agency’s bulletin initially displayed an incorrect individual PSS rate and was subsequently corrected.

The current official RBHS fee schedule should therefore be used as the primary source when verifying the applicable rate. (SCDHHS)

This illustrates why peer organizations should avoid hard-coding reimbursement rates indefinitely into operational systems.

Medicaid Qualification

Having a CPSS credential does not automatically make every service Medicaid billable.

Medicaid reimbursement may additionally depend on:

Participant eligibility
Provider enrollment
Organizational provider type
Covered service
Service authorization
Medical necessity where applicable
Service plan
Qualified CPSS
Supervision
Documentation
Correct procedure code
Correct modifier
Units
Timely claim submission
Managed care requirements

Organizations should validate each requirement separately.

Rehabilitative Behavioral Health Services

Peer Support Services appear within South Carolina Medicaid’s Rehabilitative Behavioral Health Services, or RBHS, framework. (SCDHHS)

Peer programs operating through RBHS providers should understand the broader requirements applying to their provider category rather than looking only at the H0038 procedure code.

Substance Use Peer Services

South Carolina also has a substantial peer recovery infrastructure within its substance use service system.

Peer specialists may support individuals through:

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

Current South Carolina behavioral health job postings illustrate this role in practice, including individual and group sessions, motivational interviewing, active listening, community referrals, treatment navigation, and lived-experience-based support. (BHDD)

Mental Health Peer Support

South Carolina also has a mental health peer support workforce.

Mental health peers may support participants through:

Wellness planning
Recovery planning
Self-advocacy
Community integration
Coping strategies
Natural support development
Behavioral health navigation
Goal setting
Crisis recovery
Community connection

Organizations should verify the credentialing and payer requirements applicable to the specific mental health program rather than assuming every substance use CPSS requirement applies identically.

Peer Support and Recovery Organizations

South Carolina has numerous community organizations involved in peer recovery training and service delivery.

These organizations may provide:

CPSS training
Recovery coaching
Community support
Recovery groups
Education
Outreach
Recovery events
Resource navigation
Family support
Recovery community development

Funding may come from:

Medicaid
State contracts
Federal grants
Opioid settlement funding
Local funding
Philanthropy
Other behavioral health contracts

Not every service delivered through a recovery organization is necessarily a Medicaid encounter.

Individual Peer Support

Individual peer support may involve one-on-one work such as:

Recovery planning
Goal setting
Resource navigation
Advocacy
Treatment engagement
Wellness planning
Recovery capital development
Community connection
Mentoring
Relevant lived-experience sharing

Documentation should clearly establish what occurred during the encounter.

Group Peer Support

Group peer support may include:

Recovery groups
Wellness groups
Recovery education
Skills development
Community-building activities
Recovery planning
Mutual support
Resource education

When Medicaid reimbursement is involved, organizations should distinguish qualifying H0038 HQ services from general recovery meetings or community activities.

Scope of Peer Support

Depending on the program, South Carolina peer specialists may appropriately provide:

Sharing relevant lived experience
Recovery mentoring
Recovery coaching
Goal setting
Wellness planning
Recovery planning
Self-advocacy support
Advocacy
Resource navigation
Treatment navigation
Community integration
Recovery education
Recovery capital development
Natural support development
Group peer support
Community connection
Engagement
Follow-up
Recovery maintenance support

Activities Generally Outside Peer Scope

Unless separately licensed and authorized under another professional role, a CPSS generally should not:

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

Peer support should remain grounded in lived experience, mentoring, advocacy, recovery, wellness, and connection.

Peer Supervision

South Carolina peer programs should establish clear supervision structures.

Peer supervision may address:

Appropriate use of lived experience
Recovery orientation
Ethics
Boundaries
Role fidelity
Documentation
Recovery planning
Difficult interactions
Advocacy
Community resources
Crisis escalation
Professional development
Staff wellness

Organizations billing Medicaid should separately verify applicable supervision requirements for their provider type and service.

Documentation for South Carolina Peer Support

A strong South Carolina peer support note may include:

Participant identifier
Date
Start time
End time
Duration
Location
Modality
CPSS name
Credential
Recovery goal
Service-plan goal when applicable
Peer intervention
Relevant lived-experience support
Mentoring
Advocacy
Navigation
Education
Wellness planning
Community resources
Participant response
Progress
Barriers
Follow-up
Signature or attestation

When Medicaid is billed, documentation should also support:

H0038
Individual or group status
Applicable modifier
Units
Provider requirements

Documentation Should Be

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

Documentation Should Avoid

Unsupported diagnoses
Clinical interpretations outside peer scope
Stigmatizing terminology
Generic statements such as “provided peer support”
Copy-and-paste documentation
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 support note does not automatically establish Medicaid reimbursement.

Payment may additionally depend on:

Healthy Connections eligibility
Provider enrollment
Provider qualification
CPSS qualification
Covered service
Service authorization
Medical necessity
Service plan
Correct H0038 configuration
Correct modifier
Units
Documentation
Timely filing
Managed care requirements

Organizations should validate each requirement independently.

Confidentiality

South Carolina peer programs may handle sensitive:

Mental health information
Substance use records
Recovery information
Family information
Justice information
Housing information

Applicable requirements may include:

HIPAA
42 CFR Part 2
South Carolina law
Medicaid requirements
State behavioral health requirements
Organizational policy
Participant consent

Peer staff should receive specific training on:

Documentation
Information sharing
Consent
Substance use records
Text messaging
Email
Telehealth
Social media
Care-team communication
Crisis communication

Starting a Peer Support Program in South Carolina

Step 1: Define the Population

Determine whether the program serves:

People with substance use disorders
People with mental health conditions
People with co-occurring conditions
People leaving treatment
Justice-involved populations
People experiencing homelessness
Community recovery populations
Other behavioral health populations

Step 2: Determine the Credential Pathway

Determine the specific CPSS certification requirements applicable to:

Substance use services
Mental health services
Medicaid
Employer
Contract
Population

Step 3: Build Credential Tracking

For substance use CPSS workers, track applicable:

High school diploma/GED
Recovery eligibility
Two-year recovery requirement
46 training hours
Training provider
Training completion
Certification examination
CPSS credential
Expiration
Continuing education
Renewal

Step 4: Determine Funding

Potential funding may include:

Healthy Connections Medicaid
State behavioral health contracts
Federal grants
Opioid settlement funds
Recovery community funding
Hospital contracts
Justice contracts
Philanthropy
Other grants

Step 5: Establish Medicaid Compliance

For Medicaid Peer Support Services, verify:

Provider enrollment
Provider type
CPSS qualification
Participant eligibility
Service eligibility
Authorization
Service planning
Supervision
Documentation
H0038 coding
Modifiers
Claims requirements

Step 6: Establish Supervision

Determine:

Peer supervisor
Administrative supervisor
Clinical consultant where applicable
Supervision frequency
Documentation
Crisis escalation
Staff wellness

Step 7: Build the Service Workflow

Map:

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

Step 8: Configure Individual and Group Services

Distinguish:

H0038 individual
H0038 HQ group
Qualifying telehealth
Non-Medicaid peer support

Step 9: Establish Role Boundaries

Develop policies addressing:

Use of lived experience
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
MOUD engagement
Self-advocacy
Community connection
Natural supports
Housing
Employment
Wellness
Crisis utilization
Hospitalization
Participant satisfaction
Peer workforce retention
Documentation timeliness
Credential compliance

Common Challenges for South Carolina Peer Programs

Credential Pathway Differences

Organizations should not assume every CPSS pathway has identical requirements across:

Mental health
Substance use
Medicaid
State contracts

The applicable certification and program standards should be verified before hiring or assigning billable services.

Training Capacity

South Carolina uses multiple organizations to deliver CPSS training.

Programs developing peer workforces should monitor:

Training dates
Application deadlines
Available seats
Training modality
Certification testing

Current state listings show both in-person and hybrid CPSS training options. (BHDD)

Medicaid Billing

A CPSS credential alone does not establish Medicaid billability.

The provider organization, participant, service, documentation, coding, and other requirements must also align.

Individual vs. Group Services

South Carolina Medicaid distinguishes:

H0038 individual
H0038 HQ group

Documentation systems should capture the service format before claims are generated.

Telehealth

Current Medicaid fee schedules recognize H0038 with the GT modifier for qualifying telehealth Peer Support Services. (SCDHHS)

Organizations should capture modality accurately.

Medicaid Rate Changes

South Carolina changed behavioral health reimbursement rates effective December 1, 2025 and subsequently corrected published information involving H0038. (SCDHHS)

Organizations should use current fee schedules rather than relying on historical rates.

Documentation Burden

Peers are valuable because of relationships and lived experience.

Documentation should establish accountability and support reimbursement without forcing peers to write like therapists.

Role Drift

Peers may gradually be assigned:

Generic case management
Administrative tasks
Transportation-only duties
Compliance monitoring
Clinical tasks

Organizations should protect the distinct peer role.

Frequently Asked Questions

What is South Carolina’s primary peer credential?

The Certified Peer Support Specialist, or CPSS.

How much CPSS training is required for the substance use pathway?

Current state-listed programs provide 46 hours of CPSS training. (BHDD)

How much recovery time is required?

Current substance use CPSS training prerequisites specify a minimum of two years in recovery from a substance use disorder involving alcohol and/or other drugs. (BHDD)

Is a high school diploma required?

Current substance use CPSS training prerequisites require a:

High school diploma
GED
Or higher education

(BHDD)

Does CPSS training cover medication-assisted recovery?

Yes.

Current training objectives specifically include co-occurring disorders and medication-assisted recovery. (BHDD)

Does CPSS training include documentation?

Yes.

Documentation training is specifically included in current South Carolina CPSS curriculum objectives. (BHDD)

Does South Carolina Medicaid cover peer support?

Yes.

Healthy Connections Medicaid reimburses qualifying Peer Support Services. (SCDHHS)

What is the Medicaid code?

H0038. (SCDHHS)

What is the group peer support code?

H0038 HQ. (SCDHHS)

Can Peer Support Services be delivered through telehealth?

The current fee schedule recognizes H0038 GT for qualifying telehealth delivery. (SCDHHS)

What is the current individual Medicaid PSS rate?

The current RBHS fee schedule effective December 1, 2025 lists $14.88 per unit for individual H0038 Peer Support Services. (SCDHHS)

Providers should verify current rates before billing.

What is the current group Medicaid PSS rate?

The current RBHS fee schedule lists $2.61 per unit for H0038 HQ group Peer Support Services. (SCDHHS)

Is a CPSS a therapist?

No.

The CPSS credential itself does not constitute clinical licensure.

Can a CPSS diagnose a substance use disorder?

Not on the basis of CPSS certification alone.

Can a CPSS prescribe medication?

No.

Can peers support people receiving medication for addiction treatment?

Yes.

Current CPSS training specifically addresses medication-assisted recovery. (BHDD)

Official South Carolina Peer Support Resources

South Carolina Department of Behavioral Health and Developmental Disabilities

Official state behavioral health agency providing information about behavioral health services, peer workforce development, training, and recovery services.