South Dakota Peer Support & Medicaid Guide

South Dakota’s peer support system is undergoing significant expansion and formalization.

Peer support is used across substance use recovery, mental health services, Community Mental Health Centers, substance use disorder treatment agencies, recovery support programs, and other community settings.

Two recent developments are particularly important:

South Dakota Medicaid added formal coverage for nonclinical individual and group peer support services effective June 1, 2025.
South Dakota enacted legislation in 2026 bringing Peer Support Specialists under the regulatory authority of the South Dakota Board of Addiction and Prevention Professionals.

The 2026 legislation establishes Peer Support Specialist, Peer Support Specialist Trainee, and Peer Support Specialist Supervisee as regulated professional designations and directs the Board to establish education, work experience, supervision, examination, renewal, and related requirements. (South Dakota Legislature)

Because this regulatory transition is occurring during 2026, organizations should pay particular attention to implementation dates and final Board rules rather than relying on older South Dakota peer requirements.

South Dakota Peer Support Quick Facts

Category	South Dakota overview
State Medicaid program	South Dakota Medicaid
Behavioral health authority	Division of Behavioral Health
State department	South Dakota Department of Social Services
Abbreviation	DSS
Peer role	Peer Support Specialist
New regulated title	Peer Support Specialist
Trainee designation	Peer Support Specialist Trainee
Supervisee designation	Peer Support Specialist Supervisee
Regulatory board	South Dakota Board of Addiction and Prevention Professionals
Medicaid peer support	Yes
Medicaid coverage effective	June 1, 2025
Individual peer code	H0038
Group peer code	H0025
Billing unit	15 minutes
FY27 individual rate	$17.32 per 15 minutes
FY27 group rate	$7.36 per 15 minutes
Medicaid settings	Approved CMHCs and SUD agencies
Mental health lived experience	Required for applicable peer workers
High school diploma/equivalent	Required under current Medicaid MH qualification
State-approved training	Required
Supervision	Required
State certification system	Being formally implemented under 2026 legislation
Last reviewed	August 2026

What Is Peer Support in South Dakota?

South Dakota recognizes peer support as a nonclinical recovery service grounded in lived experience.

The state’s Medicaid State Plan describes peer support as individual or group support provided throughout the substance use rehabilitation process in support of a beneficiary’s recovery and treatment goals.

Through lived experience, peer support workers help people become and remain engaged in recovery and reduce the likelihood of recurrence of substance use. (Department of Social Services)

Covered peer activities include:

Advocating for people in recovery
Sharing resources
Building skills
Linking participants to resources
Connecting participants with services and supports
Leading recovery groups
Mentoring
Setting goals

(Department of Social Services)

South Dakota also recognizes peer support within its mental health system.

Recovery Support Services in South Dakota

The South Dakota Division of Behavioral Health describes recovery support services as services that help a person with overall recovery, responsible behavior, values, and positive habits that support continued recovery.

Importantly, South Dakota states that recovery support services may be used:

Alongside traditional treatment
Instead of traditional treatment in appropriate circumstances

(Department of Social Services)

This distinction reinforces that recovery support is broader than formal clinical treatment.

South Dakota’s recovery support infrastructure includes:

Peer support
Recovery housing
Supported housing
Care coordination
Recovery programs
Treatment navigation
Community services

Peer Support Specialist

The Peer Support Specialist is becoming South Dakota’s formal regulated peer professional designation.

In 2026, South Dakota enacted House Bill 1029, which added the following titles to the professionals regulated under Chapter 36-34:

Peer Support Specialist
Peer Support Specialist Trainee
Peer Support Specialist Supervisee

(South Dakota Legislature)

This represents an important change in South Dakota’s peer workforce infrastructure.

Historically, peer qualification was largely connected to state-approved training, Medicaid provider requirements, and behavioral health program standards.

The new framework creates a formal state regulatory pathway.

South Dakota Board of Addiction and Prevention Professionals

The South Dakota Board of Addiction and Prevention Professionals is responsible for implementing the state’s new Peer Support Specialist regulatory framework.

The Board already regulates professionals including:

Certified Addiction Counselors
Licensed Addiction Counselors
Certified Prevention Specialists
Addiction Counselor Trainees
Prevention Specialist Trainees

The 2026 legislation expands this authority to include Peer Support Specialists. (South Dakota Legislature)

Major 2026 Regulatory Change

South Dakota’s 2026 peer certification changes are especially important for organizations hiring or developing peer workers.

House Bill 1029 authorizes the Board to regulate practitioners to ensure:

Professional competency
Compliance with examination requirements
Public safety

The Board is responsible for:

Examining eligible applicants
Issuing certifications and recognitions
Renewing credentials
Maintaining a public practitioner list
Handling disciplinary proceedings
Establishing professional standards

(South Dakota Legislature)

Peer Support Specialist Trainee

South Dakota’s new statutory framework specifically recognizes the title:

Peer Support Specialist Trainee

This provides a pathway for individuals who are developing the education, experience, and competencies necessary for full certification. (South Dakota Legislature)

This is particularly important for workforce development because organizations can build structured pathways from lived experience into professional peer practice.

Peer Support Specialist Supervisee

The legislation also establishes:

Peer Support Specialist Supervisee

as a recognized designation. (South Dakota Legislature)

The distinction between trainee, supervisee, and fully certified Peer Support Specialist can help organizations track workforce progression.

New Certification Requirements

As of August 2026, South Dakota is actively implementing rules governing the new certification structure.

The state has specifically indicated that the rules will establish requirements involving:

Education
Work experience
Supervision
Examination
Board-approved supervision
Renewal
Electronic service delivery

(Department of Social Services)

Organizations should therefore verify the final Board rules before publishing fixed certification requirements or making hiring decisions based on older peer standards.

Why the 2026 Change Matters

The new certification structure creates a clearer professional pathway:

Lived Experience → Training → Trainee/Supervisee → Supervised Experience → Examination → Peer Support Specialist Certification → Renewal

For organizations, this means credential management will increasingly need to account for:

Credential status
Training
Supervised experience
Supervisor
Examination
Certification
Renewal
Continuing education
Disciplinary status

Protected Peer Titles

South Dakota’s 2026 legislation establishes restrictions on using the new professional titles.

A person may not represent themselves as a:

Peer Support Specialist
Peer Support Specialist Trainee
Peer Support Specialist Supervisee

unless appropriately recognized or certified under the applicable state chapter. (South Dakota Legislature)

This makes title verification increasingly important for employers.

Public Credential Verification

The Board is directed to maintain a publicly available list containing information including:

Practitioner status
Credential number
Date granted
Renewal date
Disciplinary actions

(South Dakota Legislature)

This creates an important compliance mechanism for behavioral health organizations employing peer professionals.

Peer Certification Fees

The 2026 legislation establishes a maximum statutory fee structure that includes:

Peer Support Specialist certification, renewal, or reinstatement: $200

and recognition fees for:

Peer Support Specialist Trainees
Peer Support Specialist Supervisees

of up to $150 under the statutory framework. (South Dakota Legislature)

Actual current Board fees should be verified before applying.

Mental Health Peer Support

South Dakota Medicaid recognizes Peer Support Workers within its mental health system.

Under the approved Medicaid State Plan, a mental health Peer Support Worker must have at least:

High school diploma or equivalent
Self-attestation of lived experience
Ongoing recovery from a mental health diagnosis
Completion of Department-approved training

(Department of Social Services)

This is the current Medicaid practitioner qualification and should be distinguished from the state’s developing professional certification requirements.

Mental Health Lived Experience

South Dakota’s Medicaid mental health peer qualification explicitly requires self-attestation of lived experience and ongoing recovery from a mental health diagnosis. (Department of Social Services)

Lived experience is therefore not simply preferred experience.

It is foundational to the Medicaid peer role.

Organizations should document eligibility appropriately without requiring unnecessary disclosure of detailed personal health information.

Mental Health Peer Training

Medicaid-qualified mental health Peer Support Workers must complete Department-approved training. (Department of Social Services)

Organizations should verify current approved training requirements directly with the Division of Behavioral Health.

As the new Board certification framework is implemented, organizations should also determine how existing Department-approved training maps to Board certification requirements.

Mental Health Peer Supervision

South Dakota Medicaid requires mental health peer workers to be supervised by either:

A mental health professional as defined by the state
A peer with at least two years of direct experience providing peer services

(Department of Social Services)

Mental health professionals and experienced peers may supervise after completing state-approved Supervising Peer Support training. (Department of Social Services)

Supervisors are expected to provide regularly scheduled supervision.

Supervising Peer Support Training

South Dakota specifically recognizes peer supervision as requiring its own competencies.

Eligible supervisors must complete state-approved Supervising Peer Support training before providing applicable supervision. (Department of Social Services)

Peer supervision should address issues such as:

Appropriate use of lived experience
Role boundaries
Recovery orientation
Ethics
Documentation
Participant engagement
Community resources
Difficult interactions
Crisis escalation
Staff wellness
Professional development

Substance Use Peer Support

South Dakota Medicaid also covers peer support within the substance use disorder service system.

The state’s approved Medicaid State Plan describes these services as nonclinical individual or group support throughout all stages of substance use rehabilitation. (Department of Social Services)

Substance use peer support may include:

Recovery mentoring
Recovery planning
Treatment engagement
Resource navigation
Recovery groups
Recovery capital development
Goal setting
Advocacy
Community connection
Housing resources
Employment resources
Mutual support
Recovery maintenance

Multiple Pathways to Recovery

South Dakota’s behavioral health system recognizes that there are many ways for people to address recovery.

The Division of Behavioral Health explicitly states that there are many paths for people to address their recovery. (Department of Social Services)

Peer professionals should therefore support participant choice rather than requiring people to follow the peer’s personal recovery pathway.

Recovery Support Outside Treatment

South Dakota’s recovery support system is broader than formal substance use treatment.

The state notes that recovery support services may be used in conjunction with or instead of traditional treatment. (Department of Social Services)

This is important for:

Recovery community organizations
Peer-run programs
Recovery housing
Community support
Harm reduction programs
Post-treatment support

Not every peer interaction needs to occur inside a traditional clinical treatment program.

South Dakota Medicaid Peer Support

South Dakota Medicaid formally added coverage for nonclinical individual and group peer support through State Plan Amendment 25-0007.

The amendment became effective:

June 1, 2025

and was approved by CMS in September 2025. (Department of Social Services)

The amendment added peer support coverage and practitioner qualifications for services delivered through:

Community Mental Health Centers
Substance Use Disorder agencies

Medicaid Individual Peer Support

South Dakota Medicaid uses:

H0038

for individual Peer Support Services.

The service is billed in:

15-minute units

The current FY27 behavioral health fee schedules, effective June 1, 2026, list the rate as:

$17.32 per 15-minute unit

for identified Peer Support Providers. (Department of Social Services)

Medicaid Group Peer Support

South Dakota uses:

H0025

for group Peer Support Services.

Current state fee schedules describe the service as:

Peer services, 2 to 10 patients per 15 minutes

The FY27 rate effective June 1, 2026 is:

$7.36 per 15-minute unit

for identified Peer Support Providers. (Department of Social Services)

South Dakota Medicaid Peer Codes

Service	Code	Unit	FY27 Rate
Individual Peer Support	H0038	15 minutes	$17.32
Group Peer Support	H0025	15 minutes	$7.36

Rates effective June 1, 2026 under current Division of Behavioral Health fee schedules. (Department of Social Services)

Providers should verify current rates before billing.

Identified Peer Support Providers

South Dakota’s current fee schedules specify that peer services are available through identified Peer Support Providers. (Department of Social Services)

This is an important distinction.

An individual peer credential does not necessarily establish independent authority to bill South Dakota Medicaid.

Organizations must separately verify:

Organizational provider eligibility
Medicaid enrollment
Peer qualifications
Service eligibility
Documentation
Billing requirements

Community Mental Health Centers

South Dakota has 11 accredited Community Mental Health Centers, or CMHCs, serving the state. (Department of Social Services)

These organizations provide services including:

Screening
Assessment
Outpatient behavioral health services
Individual therapy
Group therapy
Crisis intervention
Community services

Peer support is increasingly incorporated into this broader behavioral health infrastructure.

Substance Use Disorder Agencies

South Dakota also contracts with substance use disorder treatment agencies across the state.

Services include:

Screening
Assessment
Early intervention
Detoxification
Outpatient treatment
Inpatient treatment

(Department of Social Services)

Peer support can complement these clinical services by helping people remain connected to recovery outside formal treatment encounters.

Medicaid and CHIP Peer Support

South Dakota has also clarified peer support coverage under its Children’s Health Insurance Program, or CHIP.

State Plan Amendment 25-0014 clarified that peer support services are covered under CHIP to align benefits with the Medicaid State Plan. (Department of Social Services)

Programs serving children, adolescents, or families should still verify applicable:

Age requirements
Peer qualifications
Service definitions
Consent requirements
Provider requirements

before assuming an adult peer workflow applies.

Scope of Peer Support

South Dakota’s Medicaid State Plan specifically identifies peer activities including:

Advocacy
Resource sharing
Skill building
Linking to resources
Linking to services
Linking to supports
Leading recovery groups
Mentoring
Goal setting

(Department of Social Services)

Depending on the program, peers may also support:

Recovery planning
Wellness planning
Treatment engagement
Community integration
Self-advocacy
Natural support development
Recovery capital
Housing navigation
Employment resources
Community connection
Recovery maintenance

Activities Generally Outside Peer Scope

Unless separately qualified and authorized under another professional role, a Peer Support Specialist 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

South Dakota explicitly defines Medicaid peer support as nonclinical. (Department of Social Services)

Peer Supervision

Supervision is a central part of South Dakota’s developing peer support system.

The Medicaid mental health standard requires regularly scheduled supervision by an eligible supervisor. (Department of Social Services)

The new 2026 regulatory framework also directs the Board to establish formal supervision requirements for Peer Support Specialist certification. (Department of Social Services)

Organizations should therefore distinguish between:

Medicaid supervision
Certification supervision
Administrative supervision
Clinical consultation

These requirements may overlap but are not necessarily identical.

Documentation for South Dakota Peer Support

Peer support documentation should accurately describe the recovery-oriented service that occurred.

A strong South Dakota peer note may include:

Participant identifier
Date
Start time
End time
Duration
Location
Modality
Peer worker
Credential or trainee status
Recovery goal
Treatment-plan goal when applicable
Peer intervention
Advocacy
Mentoring
Skill building
Resource navigation
Community connection
Relevant use of lived experience
Participant response
Progress
Barriers
Follow-up
Signature or attestation

Medicaid Documentation

For Medicaid-billable services, documentation should support:

Participant eligibility
Qualified provider
Qualified peer
Recovery or treatment goal
Service delivered
Individual vs. group service
Start and end time
Duration
Units
H0038 or H0025
Participant response
Follow-up

A note stating only “provided peer support” does not adequately describe the service.

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 language
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:

South Dakota Medicaid eligibility
Covered benefit
Provider enrollment
Provider qualification
Peer qualification
Service eligibility
Treatment or recovery plan
Supervision
Individual vs. group service
Correct procedure code
Units
Documentation
Timely claim submission

Organizations should validate each requirement separately.

Confidentiality

South Dakota peer workers may handle sensitive:

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

Applicable requirements may include:

HIPAA
42 CFR Part 2
South Dakota law
Medicaid requirements
Division of Behavioral Health requirements
Professional ethics
Organizational policy
Participant consent

Peer staff should receive role-specific confidentiality training.

Electronic Peer Services

South Dakota’s current rulemaking process specifically includes standards related to providing services through electronic means. (Department of Social Services)

Organizations providing remote peer support should verify current rules regarding:

Telehealth
Participant location
Peer location
Privacy
Documentation
Consent
Technology
Billing
Supervision

as the Board completes implementation of the new regulatory framework.

Starting a Peer Support Program in South Dakota

Step 1: Define the Population

Determine whether the organization serves:

People with mental health conditions
People with substance use disorders
People with co-occurring conditions
People leaving treatment
People in recovery housing
Justice-involved populations
Rural communities
Tribal communities
Youth and families
Other behavioral health populations

Step 2: Determine the Peer Pathway

Determine whether staff fall under:

Peer Support Specialist
Peer Support Specialist Trainee
Peer Support Specialist Supervisee
Existing Medicaid Peer Support Worker requirements

Because the certification framework is changing in 2026, verify current Board rules.

Step 3: Verify Lived Experience

For applicable Medicaid mental health peer roles, verify qualifying lived experience and ongoing recovery.

Avoid collecting unnecessary details beyond what is needed to establish eligibility.

Step 4: Complete Approved Training

Verify current:

Department-approved training
Board-approved training
Supervising Peer Support training
Specialty training

depending on the role.

Step 5: Build Credential Tracking

Track:

Peer status
Training
Trainee recognition
Supervisee recognition
Supervised work experience
Supervisor
Examination
Certification
Credential number
Issue date
Renewal date
Continuing education
Disciplinary status

Step 6: Establish Supervision

Determine:

Peer supervisor
Mental health professional supervisor
Board-approved supervisor
Administrative supervisor
Frequency
Documentation
Crisis escalation
Staff wellness

Step 7: Determine Funding

Potential funding may include:

South Dakota Medicaid
CHIP
Division of Behavioral Health contracts
Federal block grants
Opioid settlement funds
Recovery support grants
Justice funding
Tribal funding
Hospital contracts
Philanthropy

Step 8: Establish Medicaid Compliance

For Medicaid services, verify:

Provider eligibility
Medicaid enrollment
Peer qualification
Participant eligibility
Covered service
Service planning
Supervision
Documentation
H0038 individual services
H0025 group services
Units
Claims

Step 9: Build the Service Workflow

Map:

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

Step 10: Measure Outcomes

Potential outcomes include:

Engagement
Recovery goal progress
Recovery capital
Treatment engagement
Self-advocacy
Community connection
Natural supports
Housing stability
Employment
Recovery maintenance
Crisis utilization
Hospitalization
Participant satisfaction
Peer workforce retention
Credential progression
Documentation timeliness

Rural Peer Support in South Dakota

Geography is an especially important consideration in South Dakota.

Behavioral health organizations may serve participants across large geographic areas with limited local service availability.

Peer support can help address:

Transportation barriers
Treatment access
Isolation
Limited recovery infrastructure
Long distances between providers
Community reintegration
Continuity after treatment

South Dakota maintains a county-level behavioral health provider directory to help residents locate mental health and substance use services. (Department of Social Services)

Tribal Communities

South Dakota peer programs may also serve American Indian communities and tribal health systems.

Organizations should recognize that tribal nations have their own:

Governments
Health systems
Cultural traditions
Recovery resources
Community structures
Data governance considerations

Peer programs working with tribal communities should be designed in partnership with those communities rather than simply applying a generic statewide model.

Opioid Settlement Funding

South Dakota has expanded the framework for using opioid settlement funds across the continuum of opioid remediation.

The state specifically identifies investment in:

Prevention
Treatment
Recovery support
Strategies to reduce recurrence of substance use

as eligible areas of focus. (Department of Social Services)

Peer support organizations may therefore encounter funding models beyond Medicaid reimbursement.

Common Challenges for South Dakota Peer Programs

Rapid Regulatory Change

The most important current issue is that South Dakota’s formal Peer Support Specialist certification system is being implemented during 2026.

Organizations should not rely exclusively on older peer qualification materials.

Medicaid vs. State Certification

South Dakota Medicaid already has practitioner qualifications for peer services, while the Board is now implementing a broader state certification system.

Organizations need to understand how these frameworks interact.

Trainee and Supervisee Tracking

The new regulatory framework recognizes:

Peer Support Specialist Trainee
Peer Support Specialist Supervisee
Peer Support Specialist

Workforce systems should distinguish these statuses.

Supervision

South Dakota requires meaningful peer supervision.

Programs should track:

Supervisor
Supervisor qualification
Required training
Supervision dates
Supervision hours
Topics
Credential progression

Rural Access

Large service areas can make:

In-person engagement
Supervision
Training
Referral coordination
Follow-up

more difficult.

Medicaid Billing

Individual and group peer services use different codes:

H0038
H0025

Documentation systems should assign these based on the actual service delivered.

Medicaid vs. Grant-Funded Services

Not every valuable peer interaction is Medicaid billable.

Organizations need to track services funded through:

Medicaid
State contracts
Grants
Opioid settlements
Other funding

without losing visibility into total peer activity.

Documentation Burden

Peer support is fundamentally relationship-based.

Compliance systems should support accountability without forcing peers to document as if they were therapists.

Role Drift

Peers may gradually be assigned:

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

Organizations should preserve the distinct peer role.

Frequently Asked Questions

What is South Dakota’s peer credential?

South Dakota enacted legislation in 2026 establishing Peer Support Specialist as a regulated professional designation. (South Dakota Legislature)

Does South Dakota have a Peer Support Specialist Trainee designation?

Yes. (South Dakota Legislature)

Does South Dakota have a Peer Support Specialist Supervisee designation?

Yes. (South Dakota Legislature)

Who regulates Peer Support Specialists?

The South Dakota Board of Addiction and Prevention Professionals under the new statutory framework. (South Dakota Legislature)

Are the certification requirements changing?

Yes.

South Dakota is implementing rules addressing education, experience, supervision, examination, renewal, and other Peer Support Specialist requirements during 2026. (Department of Social Services)

Does lived experience matter?

Yes.

For Medicaid mental health peer workers, current qualifications explicitly require self-attestation of lived experience and ongoing recovery from a mental health diagnosis. (Department of Social Services)

Is a high school diploma required?

For Medicaid mental health Peer Support Workers, the current state qualification requires at least a high school diploma or equivalent. (Department of Social Services)

Is training required?

Yes.

Medicaid mental health Peer Support Workers must complete Department-approved training. (Department of Social Services)

The new Board certification system will also establish applicable education and training requirements.

Is supervision required?

Yes.

South Dakota’s Medicaid mental health peer qualification requires regularly scheduled supervision. (Department of Social Services)

The developing certification system also includes formal supervision requirements.

Can an experienced peer supervise another peer?

Under the current Medicaid mental health standard, a peer with at least two years of direct peer-service experience may supervise after completing state-approved Supervising Peer Support training. (Department of Social Services)

Does South Dakota Medicaid cover peer support?

Yes.

Formal Medicaid coverage became effective June 1, 2025. (Department of Social Services)

What is the current individual peer rate?

The FY27 rate effective June 1, 2026 is $17.32 per 15 minutes for identified Peer Support Providers. (Department of Social Services)

What is the current group peer rate?

The FY27 rate is $7.36 per 15 minutes for qualifying group peer services. (Department of Social Services)

How many people can participate in Medicaid group peer support?

The current fee schedule describes H0025 group peer services as serving 2 to 10 patients per 15 minutes. (Department of Social Services)

Does CHIP cover peer support?

South Dakota clarified peer support coverage under CHIP through State Plan Amendment 25-0014. (Department of Social Services)

Are peer services clinical treatment?

No.

South Dakota’s Medicaid State Plan specifically characterizes peer support as nonclinical. (Department of Social Services)

Official South Dakota Peer Support Resources

South Dakota Division of Behavioral Health

Official state behavioral health resource covering mental health, substance use disorder treatment, recovery support, peer support, recovery housing, crisis services, and other behavioral health programs.