Vermont Peer Support & Medicaid Guide

Vermont’s peer support system is undergoing an important transition toward formal state certification and Medicaid reimbursement.

As of 2026, Vermont now recognizes two separate state-certified peer roles under 26 V.S.A. Chapter 60:

Peer Support Provider, or PSP, associated primarily with mental health peer support
Peer Recovery Support Specialist, or PRSS, associated primarily with substance use recovery support

Both certifications are administered through the Vermont Office of Professional Regulation, or OPR. The certification framework became effective July 1, 2025. (Vermont Legislature)

For substance use recovery, the Vermont Department of Health has also established a broader Recovery Support Services, or RSS, initiative. This includes certification of Recovery Services Organizations, formal PRSS certification, and development of a Medicaid recovery support benefit. The first Medicaid recovery coaching benefit is currently anticipated for implementation in 2027. (Vermont Department of Health)

This means Vermont differs from states where a mature Medicaid H0038 peer benefit has already been operating for years. As of August 2026, Vermont is still building the certification, organizational, and Medicaid infrastructure for its newer recovery support system.

Vermont Peer Support Quick Facts

Category	Vermont overview
State Medicaid program	Vermont Medicaid
Mental health peer credential	Peer Support Provider
Abbreviation	PSP
Substance use recovery credential	Peer Recovery Support Specialist
Abbreviation	PRSS
State certification authority	Vermont Office of Professional Regulation
PSP credentialing body	Approved by Vermont Department of Mental Health
PRSS credentialing body	Approved by Vermont Department of Health
Minimum certification age	18
Credential from approved credentialing body	Required
Criminal history/registry review	May be required
PRSS underlying credential	Vermont Certified Recovery Coach / IC&RC Peer Recovery credential
PRSS ethics agreement	Required
State certification cycle	Biennial
State regulatory framework effective	July 1, 2025
Recovery Services Organization certification	Implemented
Medicaid RSS benefit	In development
Initial recovery coaching Medicaid benefit	Anticipated 2027
Current PRSS application	Available
Last reviewed	August 2026

What Is Peer Support in Vermont?

Vermont recognizes peer support as a distinct lived-experience role within behavioral health and recovery systems.

For mental health, Peer Support Providers use lived experience to support people navigating:

Mental health challenges
Recovery
Wellness
Crisis systems
Community integration
Self-determination
Behavioral health services

For substance use recovery, Peer Recovery Support Specialists provide peer-based recovery support rooted in shared experience and recovery expertise.

The Vermont Department of Health describes peer recovery services as a cornerstone of the state’s recovery support system. These services can include:

One-on-one peer meetings
Peer-led support
Support groups
Shared-experience support
Recovery activities
Practical recovery navigation

(Vermont Department of Health)

Peer support remains distinct from psychotherapy, diagnosis, prescribing, and other services requiring professional clinical licensure.

Vermont’s Two State Peer Certifications

Vermont law now distinguishes between two certified peer roles.

Certified Peer Support Provider

The Peer Support Provider, or PSP, is the state-certified peer role associated with Vermont’s mental health system.

The Vermont Department of Mental Health approves the credentialing body used for PSP certification. (Vermont Outside)

Certified Peer Recovery Support Specialist

The Peer Recovery Support Specialist, or PRSS, is the state-certified role associated with substance use recovery services.

The Vermont Department of Health approves the PRSS credentialing body, while the Vermont Office of Professional Regulation issues the state certification. (Vermont Outside)

These roles are related but should not be treated as interchangeable.

Vermont Office of Professional Regulation

The Vermont Office of Professional Regulation now formally regulates:

Peer Support Providers
Peer Recovery Support Specialists

under 26 V.S.A. Chapter 60. (Vermont Legislature)

The system creates a distinction between:

Credentialing

and

State certification.

An applicant first obtains the applicable credential through an approved credentialing body.

The applicant then applies to the Office of Professional Regulation for certification.

Peer Recovery Support Specialist Eligibility

Under Vermont statute, a PRSS applicant must:

Be at least 18 years old
Hold a credential from the approved Peer Recovery Support Specialist credentialing body
Complete the state application
Pay applicable fees
Satisfy applicable criminal history or registry requirements

(Vermont Legislature)

Peer Support Provider Eligibility

The statutory requirements for a PSP follow a similar structure.

An applicant must:

Be at least 18 years old
Hold a credential from the approved Peer Support Provider credentialing body
Complete the state application
Pay applicable fees
Meet applicable registry or criminal-history requirements

(Vermont Legislature)

Credentialing Bodies

Vermont’s administrative rules require credentialing bodies to receive state approval.

The:

Department of Mental Health approves the PSP credentialing body
Department of Health approves the PRSS credentialing body

No organization may operate one of these formal credentialing programs without the appropriate state approval. (Vermont Outside)

PRSS Credentialing Requirement

The Vermont Department of Health states that a person seeking PRSS certification must first obtain the IC&RC Peer Recovery credential through Vermont’s approved credentialing process.

In Vermont, this credential is known as the:

Certified Recovery Coach, or CRC.

The credentialing process is coordinated by Prevention Works!VT. (Vermont Department of Health)

The pathway is therefore:

Recovery Coach Training → Vermont Certified Recovery Coach Credential → OPR Peer Recovery Support Specialist Certification

Existing Certified Recovery Coaches

Vermont has specifically addressed workers who already hold the Certified Recovery Coach credential.

The Department of Health states that people who currently hold Vermont’s IC&RC-based Certified Recovery Coach credential are eligible to apply for Office of Professional Regulation PRSS certification. (Vermont Department of Health)

This provides a bridge from Vermont’s older recovery coach infrastructure into the new state-certified PRSS profession.

PRSS Training

Vermont’s administrative rules require the approved PRSS credentialing body to ensure that applicants have:

Signed the Peer Recovery Support Specialist Code of Ethics
Successfully completed Department of Health-approved training

before receiving the credential used for state certification. (Vermont Outside)

Specific approved training requirements should be verified through Prevention Works!VT and the Vermont Department of Health because the credentialing process is tied to the IC&RC Certified Recovery Coach pathway.

Certified Recovery Coach

Vermont continues to publicly recognize the Certified Recovery Coach, or CRC, credential.

The Vermont Department of Health states that Prevention Works!VT coordinates the Certified Recovery Coach certification process. (Vermont Department of Health)

Recovery Coaches may have lived experience as:

People in recovery
Family members
Allies

and use specialized training to support people working to overcome substance use disorders. (Vermont Department of Health)

The newer PRSS certification builds on this credential.

Recovery Coach vs. PRSS

These terms should not be treated as identical.

A Certified Recovery Coach is the credential issued through the approved credentialing body.

A Certified Peer Recovery Support Specialist is the state professional certification issued through OPR.

Under Vermont’s new framework:

CRC credential → PRSS state certification

for qualifying applicants. (Vermont Department of Health)

PRSS Code of Ethics

Vermont requires Peer Recovery Support Specialists to practice according to a formal Code of Ethics.

The administrative rules incorporate the Code of Ethics for Certified Peer Recovery Support Specialists as the standard of professional practice and fitness. (Vermont Outside)

The Vermont Department of Health has also published a revised PRSS Code of Ethics as part of implementation of the Recovery Support Services initiative. (Vermont Department of Health)

Ethical peer practice may involve:

Appropriate use of lived experience
Boundaries
Confidentiality
Participant autonomy
Professional conduct
Recovery orientation
Conflicts of interest
Respect for multiple recovery pathways

Mental Health Peer Certification

Vermont’s Department of Mental Health is separately developing and implementing the Peer Support Providercertification pathway.

Public state materials identify:

Statewide peer certification work
Credentialing coordinated through the Copeland Center
Training collaboration with Pathways Vermont

as part of Vermont’s current mental health peer certification infrastructure. (Vermont Legislature)

Organizations should use current Department of Mental Health and OPR guidance because implementation has continued to evolve.

Mental Health Peer Training

Current Vermont Department of Mental Health materials describe collaboration with Pathways Vermont on training peers pursuing certification.

The state has also worked to adapt the curriculum to Vermont’s peer support principles and behavioral health environment. (Vermont Legislature)

The exact current curriculum and certification requirements should be verified through the Department of Mental Health and the approved credentialing body.

Peer Support Certification and Reciprocity

Earlier Vermont stakeholder work recommended against automatic reciprocity for out-of-state peer credentials because of the importance of Vermont-specific peer support values, principles, and system knowledge. (Vermont Mental Health)

Applicants coming from another state should therefore verify the current OPR and credentialing-body rules rather than assuming another state’s peer credential will automatically qualify.

Certification Renewal

Vermont’s administrative rules require PRSS certification to be renewed on a biennial basis.

For renewal, the professional must provide a current credential from the approved PRSS credentialing body. (Vermont Outside)

The PRSS manual further explains that Vermont uses fixed profession-wide renewal dates.

After the first applicable renewal, the credential generally follows a full two-year cycle. (Vermont Department of Health)

Initial Certification and Renewal Timing

Vermont’s PRSS manual explains that initial certifications may have different first expiration periods depending on when they are issued.

If the initial certification is issued within 90 days of the profession’s renewal date, it remains valid through the next full renewal cycle.

If issued more than 90 days before the renewal date, the professional must renew at the upcoming profession-wide renewal date. (Vermont Department of Health)

Organizations should therefore track the actual OPR expiration date rather than assuming every initial credential lasts exactly two years.

Certification Fees

Current Vermont statute lists an application fee of:

$50

for Peer Support Providers and Peer Recovery Support Specialists through June 30, 2027.

The statute increases this amount to:

$75 beginning July 1, 2027. (Vermont Legislature)

Applicants should verify current OPR fees before applying.

Criminal History Review

Vermont law allows the Office of Professional Regulation to obtain criminal-history records when acting on initial or renewal applications for regulated professions including certified peer workers.

This may include:

Vermont criminal history
Out-of-state criminal history
FBI criminal history
Fingerprint-supported checks

where applicable. (Vermont Legislature)

A criminal record should not automatically be interpreted outside the state’s actual review process.

Substance Use Recovery Support

Peer recovery services are an important part of Vermont’s substance use recovery system.

The Vermont Department of Health describes peer recovery services as involving:

Certified Peer Recovery Support Specialists
One-on-one peer meetings
Support groups
Mutual encouragement
Recovery activities
Shared lived experience
Practical recovery tools

(Vermont Department of Health)

Peers may help participants with:

Recovery planning
Treatment engagement
Recovery capital
Community resources
Mutual support
Housing resources
Employment resources
Self-advocacy
Recovery maintenance
Community connection

Recovery Support Services Initiative

The Vermont Department of Health is implementing a major statewide Recovery Support Services, or RSS, initiative.

The initiative includes three interconnected efforts:

Recovery Services Organization certification
Peer Recovery Support Specialist certification
Development of a Medicaid Recovery Support Services benefit

(Vermont Department of Health)

Recovery Services Organizations

Vermont has created a formal Recovery Services Organization, or RSO, certification framework.

The Department of Health defines an RSO as a:

Nonresidential
Nonclinical

organization certified to provide recovery services and supports according to state standards. (Vermont Department of Health)

This formalizes recovery organizations separately from traditional treatment-provider certification.

Why RSO Certification Matters

Beginning after the state’s implementation deadline, organizations that are not certified as Recovery Services Organizations are not eligible to receive applicable state or federal Department of Health funding for recovery support services.

The Department of Health identifies June 30, 2026 as the key deadline associated with this requirement. (Vermont Department of Health)

This makes organizational certification an important component of Vermont’s recovery support infrastructure.

Medicaid Recovery Support Services

Vermont is establishing Recovery Support Services as a Medicaid-reimbursable benefit.

However, the benefit is still being implemented.

The Vermont Department of Health’s current timeline identifies the initial Medicaid recovery coaching benefit as anticipated for:

2027. (Vermont Department of Health)

This distinction is important.

As of August 2026, organizations should not assume Vermont already has a fully implemented statewide Medicaid recovery coaching benefit identical to peer reimbursement systems in other states.

Who Will Provide Medicaid Recovery Services?

Vermont’s current public guidance states that, for the forthcoming Recovery Support Services Medicaid benefit, reimbursable services will need to be provided by:

Certified Peer Recovery Support Specialists

employed by a:

Vermont Department of Health Certified Recovery Services Organization. (Vermont Department of Health)

This creates a two-part structure:

Qualified Individual + Qualified Organization

Vermont Medicaid Implementation Path

Based on the state’s public implementation materials, the emerging pathway is:

Certified Recovery Coach → OPR PRSS Certification → Employment by Certified RSO → Medicaid Recovery Support Service

when the applicable Medicaid benefit is implemented.

Providers should verify the final Medicaid requirements before billing because coding, rates, service definitions, authorization, and documentation standards remain part of ongoing implementation.

Medicaid Coding

As of August 2026, Vermont’s public Recovery Support Services materials do not yet establish a final fully implemented statewide Medicaid billing structure comparable to mature peer benefits in some other states.

The state is still preparing the initial Recovery Support Services Medicaid benefit for anticipated implementation in 2027. (Vermont Department of Health)

Organizations should therefore avoid assuming:

H0038
Specific modifiers
Specific billing units
Specific rates
Group limits
Prior authorization requirements

until final Vermont Medicaid guidance is published.

Recovery Support Services Are Nonclinical

Vermont defines Recovery Services Organizations as nonclinical organizations. (Vermont Department of Health)

This reinforces the distinction between:

Recovery support

and

Clinical substance use disorder treatment.

A recovery organization may work closely with treatment providers without itself becoming a clinical treatment program.

Vermont Substance Use Workforce

The Vermont Department of Health publicly identifies several substance use workforce roles involving lived experience, including:

Recovery Coach
Recovery Services Specialist
Harm Reduction Specialist

The state specifically identifies lived experience or certification as relevant preparation for recovery coaching and related recovery support roles. (Vermont Department of Health)

Mental Health Peer Support

Vermont also has a longstanding mental health peer community.

Mental health peer support may help people with:

Recovery
Self-determination
Wellness
Psychiatric system navigation
Crisis recovery
Community integration
Natural support development
Self-advocacy
Goal setting
Social connection

The newer Peer Support Provider certification formalizes this workforce within Vermont’s professional regulatory structure.

Peer Support Values

Vermont’s mental health peer certification development has placed particular emphasis on preserving peer support values.

Public state reports discuss concerns involving:

Peer drift
Maintaining peer identity
Vermont-specific peer values
Appropriate supervision
Peer-led credentialing and training

(Vermont Mental Health)

Organizations should therefore avoid structuring peer roles as simply lower-level clinical positions.

Peer Supervision

Peer supervision is an important issue in Vermont.

The Department of Health has publicly highlighted the distinction between:

Appropriate peer support supervision
Traditional clinical supervision

and the risk of peer drift when peer workers are integrated into conventional behavioral health organizations. (Vermont Department of Health)

Peer-focused supervision may address:

Use of lived experience
Ethics
Mutuality
Boundaries
Recovery orientation
Role fidelity
Self-determination
Documentation
Difficult interactions
Professional development
Worker wellness

Scope of Peer Support

Depending on credential and setting, Vermont peer workers may appropriately support people through:

Sharing relevant lived experience
Recovery mentoring
Recovery planning
Self-advocacy
Wellness support
Community navigation
Resource connection
Natural support development
Community integration
Recovery education
Mutual support
Goal setting
Recovery capital development
Group peer support

Activities Generally Outside Peer Scope

Unless separately licensed and authorized, a peer professional generally should not:

Diagnose mental illness
Diagnose substance use disorders
Conduct psychotherapy
Provide licensed counseling
Prescribe medication
Provide medical advice
Conduct clinical assessments requiring professional licensure
Independently modify clinical treatment
Make involuntary treatment decisions
Represent themselves as a licensed clinician
Provide legal advice

Peer support can complement clinical treatment without becoming clinical treatment.

Documentation for Vermont Peer Support

A strong Vermont peer support record may include:

Participant identifier
Date
Start and end time
Duration
Location or modality
Peer worker
Credential
Recovery or wellness goal
Peer activity
Relevant use of lived experience
Recovery support
Mentoring
Resource navigation
Community connection
Participant response
Progress
Barriers
Follow-up
Signature or attestation

Specific Medicaid documentation requirements should be added once Vermont publishes final Recovery Support Services billing guidance.

Documentation Should Be

Accurate
Timely
Person-centered
Recovery-oriented
Peer-aligned
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 notes
Unnecessary sensitive information
Services that did not occur
Personal opinions presented as clinical facts
Documentation written solely to resemble clinical treatment

Confidentiality

Vermont peer organizations may handle sensitive:

Mental health information
Substance use information
Recovery information
Family information
Justice-system information

Applicable requirements may include:

HIPAA
42 CFR Part 2
Vermont law
Department of Health requirements
Department of Mental Health requirements
Professional ethics
Organizational policies
Participant consent

Peer workers should receive role-specific training addressing:

Information access
Documentation
Participant authorization
Care-team communication
Substance use records
Text messaging
Email
Telehealth
Social media
Crisis communication

Starting a Peer Support Program in Vermont

Step 1: Define the Population

Determine whether the organization primarily serves:

People with mental health conditions
People with substance use disorders
People with co-occurring conditions
Community recovery populations
People transitioning from treatment
Other behavioral health populations

Step 2: Determine the Peer Role

Determine whether staff need:

Peer Support Provider certification
Peer Recovery Support Specialist certification
Certified Recovery Coach credential
Another applicable recovery credential

Step 3: Determine the Credentialing Pathway

For PRSS workers, the public pathway currently involves:

Approved recovery coach training
Vermont Certified Recovery Coach credential
OPR PRSS certification

For PSP workers, verify the current Department of Mental Health-approved credentialing process.

Step 4: Determine Organizational Certification

Substance use recovery organizations should determine whether Recovery Services Organization certification applies.

This is particularly important for organizations receiving Department of Health recovery-support funding and those planning to participate in the forthcoming Medicaid benefit.

Step 5: Build Credential Tracking

Track:

Peer role
Credentialing body
Underlying peer credential
OPR certification
Credential number
Issue date
Renewal date
Code of Ethics
Training
Continuing education
Current credential status

Step 6: Establish Supervision

Determine:

Peer supervisor
Administrative supervisor
Clinical consultant where applicable
Supervision frequency
Role-fidelity support
Documentation
Crisis escalation

Step 7: Determine Funding

Potential publicly documented funding structures include:

Vermont Department of Health funding
Vermont Department of Mental Health funding
Federal behavioral health grants
Recovery support grants
Future Medicaid Recovery Support Services
Other public or private contracts

Step 8: Build the Service Workflow

Map:

Referral or community access
Intake
Consent
Peer assignment
Recovery goals
Scheduling
Service delivery
Documentation
Supervision
Follow-up
Outcomes
Funding/reporting requirements

Step 9: Prepare for Medicaid RSS

Organizations planning to participate in Vermont’s emerging Medicaid Recovery Support Services benefit should monitor final state guidance involving:

Eligibility
Certified RSO status
PRSS status
Covered service definitions
Billing codes
Units
Rates
Documentation
Authorization
Claims

Step 10: Measure Outcomes

Potential outcomes include:

Engagement
Recovery goal progress
Recovery capital
Treatment engagement
Self-advocacy
Community connection
Natural supports
Housing
Employment
Wellness
Crisis utilization
Participant satisfaction
Peer workforce retention
Credential compliance

Common Challenges for Vermont Peer Programs

A New Regulatory System

Vermont’s PSP and PRSS certification framework became effective only in 2025.

Organizations should use current 2026 guidance rather than relying heavily on older Vermont peer terminology.

Credential vs. State Certification

For PRSS professionals, the Certified Recovery Coach credential and OPR PRSS certification are related but distinct.

Organizations should track both.

Mental Health vs. Substance Use Peer Roles

Vermont distinguishes:

PSP for the mental health peer system
PRSS for substance use recovery support

These should not automatically be treated as interchangeable.

Organizational Certification

Substance use recovery organizations now have a formal RSO certification framework.

Individual peer certification does not replace organizational certification.

Medicaid Is Still Being Implemented

The state’s first major Recovery Support Services Medicaid benefit is anticipated for 2027. (Vermont Department of Health)

Organizations should avoid prematurely building workflows around assumed codes or reimbursement rates.

Peer Drift

Vermont has publicly identified the risk of peer workers losing the distinct values and nature of the peer role when integrated into traditional behavioral health settings. (Vermont Department of Health)

Supervision and organizational design should protect peer role fidelity.

Documentation Burden

As Medicaid reimbursement expands, Vermont will need to balance accountability with maintaining peer support as a nonclinical, relationship-based service.

Rural Access

Vermont’s geography can create challenges involving:

Transportation
Workforce availability
Access to recovery services
Training
Supervision
Community resources

Remote and community-based service models may help where permitted.

Frequently Asked Questions

What are Vermont’s state-certified peer roles?

Vermont recognizes:

Peer Support Provider
Peer Recovery Support Specialist

under 26 V.S.A. Chapter 60. (Vermont Legislature)

When did the certification framework take effect?

The statutory framework became effective July 1, 2025. (Vermont Legislature)

Who issues the certifications?

The Vermont Office of Professional Regulation.

How old must an applicant be?

At least 18 years old. (Vermont Legislature)

Is an underlying peer credential required?

Yes.

Applicants must hold a credential from the applicable state-approved credentialing body. (Vermont Legislature)

Who approves the mental health credentialing body?

The Vermont Department of Mental Health. (Vermont Outside)

Who approves the PRSS credentialing body?

The Vermont Department of Health. (Vermont Outside)

What credential is used for the PRSS pathway?

Vermont uses the IC&RC Peer Recovery credential, known in Vermont as the Certified Recovery Coach credential, through Prevention Works!VT. (Vermont Department of Health)

Can an existing Certified Recovery Coach apply for PRSS certification?

Yes.

The Department of Health states that current Vermont IC&RC Certified Recovery Coaches are eligible to apply for OPR PRSS certification. (Vermont Department of Health)

Is a Code of Ethics required?

Yes.

PRSS applicants must sign the Peer Recovery Support Specialist Code of Ethics through the credentialing process. (Vermont Outside)

How often does PRSS certification renew?

Biennially. (Vermont Outside)

Does Vermont have Recovery Services Organization certification?

Yes.

Vermont has implemented a formal certification framework for Recovery Services Organizations. (Vermont Department of Health)

What is a Recovery Services Organization?

A nonresidential, nonclinical organization certified by the Vermont Department of Health to provide recovery services and supports according to state standards. (Vermont Department of Health)

Does Vermont Medicaid cover recovery coaching yet?

Vermont is developing the benefit.

Current state materials anticipate the initial Medicaid recovery coaching benefit in 2027. (Vermont Department of Health)

Who will be able to provide reimbursable Medicaid recovery support?

Current public guidance says services will need to be provided by a Certified Peer Recovery Support Specialist employed by a Vermont Department of Health Certified Recovery Services Organization. (Vermont Department of Health)

What Medicaid code will Vermont use?

Final public guidance for the new Recovery Support Services benefit should be consulted when implementation occurs.

As of August 2026, the benefit is still being developed, so organizations should not assume a specific H-code or modifier.

Are Vermont peer professionals clinicians?

No.

PSP and PRSS certification establish peer professional roles, not clinical licensure.

Official Vermont Peer Support Resources

Vermont Peer Recovery Support Specialist Certification

Official Vermont Department of Health Recovery Support Services hub containing PRSS certification resources, the PRSS Manual, application resources, Code of Ethics, Recovery Services Organization certification, and Medicaid implementation information.