Virginia Peer Support & Medicaid Guide

Virginia has a formal statewide peer recovery infrastructure spanning mental health, substance use recovery, co-occurring behavioral health conditions, family support, Medicaid-funded behavioral health services, community-based recovery programs, hospitals, treatment organizations, and other behavioral health settings.

Virginia distinguishes among three important peer workforce concepts:

Peer Recovery Specialist, or PRS
Certified Peer Recovery Specialist, or CPRS
Registered Peer Recovery Specialist, or RPRS

A Peer Recovery Specialist is the underlying professional role. A Certified Peer Recovery Specialist has obtained an approved professional peer certification. A Registered Peer Recovery Specialist has also registered with the Virginia Board of Counseling, which is required for Medicaid-reimbursable peer services. Virginia’s regulations define peer recovery support as collaborative, nonclinical, peer-to-peer services supporting recovery, resiliency, wellness, and self-help. (Virginia Law)

The Virginia Department of Behavioral Health and Developmental Services, or DBHDS, establishes the state’s Peer Recovery Specialist qualifications and manages the required 72-hour PRS training. The Virginia Certification Board, or VCB, is an IC&RC member board that awards the Virginia Certified Peer Recovery Specialist credential. (DBHDS)

Virginia Peer Support Quick Facts

Category	Virginia overview
State Medicaid program	Virginia Medicaid
State behavioral health authority	Virginia Department of Behavioral Health and Developmental Services
Abbreviation	DBHDS
Peer professional role	Peer Recovery Specialist
Abbreviation	PRS
Virginia certification	Certified Peer Recovery Specialist
Abbreviation	CPRS
Medicaid registration	Registered Peer Recovery Specialist
Abbreviation	RPRS
State peer training	72 hours
Education	High school diploma/GED
Minimum recovery standard used by approved certifying bodies	At least 1 year
Peer work experience for VCB CPRS	500 hours
On-the-job supervision for VCB CPRS	25 hours
Certification examination	IC&RC Peer Recovery examination
CPRS renewal	Every 2 years
CPRS continuing education	20 hours
Ethics CE	6 hours
Medicaid peer support	Yes
Family Support Partners	Yes
Medicaid service unit	15 minutes
Medicaid group ratio	Maximum 10 individuals per PRS
Standard daily Medicaid limit	4 hours / 16 units
Standard annual Medicaid limit	900 hours
Last reviewed	August 2026

What Is Peer Support in Virginia?

Virginia defines peer recovery support services as collaborative, nonclinical, peer-to-peer services designed to:

Engage people
Educate people
Support self-help
Improve health
Promote recovery
Promote resiliency
Promote wellness
Support sustained recovery from mental illness, addiction, or both

Virginia defines a Peer Recovery Specialist as someone professionally qualified through education and experience to provide collaborative services assisting people in sustained recovery from mental illness, addiction, or both. (Virginia Law)

Peer support may involve:

Recovery mentoring
Recovery planning
Wellness support
Self-advocacy
Community resource navigation
Recovery education
Goal development
Coping support
Natural support development
Community integration
Treatment engagement
Crisis support
Family support

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

Peer Recovery Specialist

The Peer Recovery Specialist, or PRS, is Virginia’s foundational professional peer role.

DBHDS describes Peer Recovery Specialists as people who use lived experience to support recovery, self-determination, and wellness. (DBHDS)

Virginia’s formal PRS qualification structure requires a person to meet state standards involving:

Education
Peer training
Ethics
Certification
Lived experience
Peer support work experience

The PRS role applies to people supporting recovery from:

Mental illness
Substance use disorders
Both

Certified Peer Recovery Specialist

The Certified Peer Recovery Specialist, or CPRS, is a professional certification available through the Virginia Certification Board.

VCB describes the CPRS as a:

Role model
Mentor
Advocate
Motivator

rather than a:

Sponsor
Case manager
Therapist

The role complements professional behavioral health services rather than replacing them. (Virginia Certification Board)

Registered Peer Recovery Specialist

A Registered Peer Recovery Specialist, or RPRS, is a Peer Recovery Specialist who has registered with the Virginia Board of Counseling.

Virginia’s regulations define an RPRS as a Peer Recovery Specialist registered by the Board of Counseling. (Virginia Law)

DBHDS states that CPRSs and nationally certified peer specialists must become registered with the Board of Counseling for their services to be billed to Medicaid. (DBHDS)

The pathway is therefore generally:

PRS Training → Approved Peer Certification → Board of Counseling Registration → RPRS

when Medicaid reimbursement is required.

Education Requirement

Virginia requires a Peer Recovery Specialist to have at least:

High school diploma
Or equivalent

This requirement is established in Virginia’s Peer Recovery Specialist regulations. (Virginia Law)

A college degree is not required.

Lived Experience Requirement

Virginia’s approved peer certification standards require lived experience.

DBHDS may approve a certifying organization whose credential requires at least:

One year of recovery

for a person with lived experience involving:

Mental illness
Substance use disorder

or qualifying lived experience as a family member of someone with a mental illness or substance use disorder. (Virginia Law)

Virginia also recognizes certain family lived-experience pathways.

A qualified person may act as a Peer Recovery Specialist based on experience as:

A parent of a minor or adult child with a similar mental illness or substance use disorder
An adult with personal experience supporting a family member with a similar mental illness or substance use disorder

when the other applicable qualifications are met. (Virginia Law)

Virginia’s 72-Hour PRS Training

Virginia requires completion of the DBHDS 72-hour Peer Recovery Specialist training.

DBHDS states that:

The 72-hour course is the Virginia PRS curriculum
DBHDS is the sole manager of the training process
Trainers must be approved by DBHDS
The training is required for certification to be recognized in Virginia

(DBHDS)

Applicants must apply and receive approval before attending the training.

What the 72-Hour Training Covers

Virginia regulations require the PRS curriculum to address topics including:

Mental health and substance use knowledge
Recovery processes
Recovery supports and strategies
Peer-to-peer services
Crisis intervention
The role and value of Peer Recovery Specialists
Health and wellness
Recovery, resiliency, and wellness planning
Stage-appropriate recovery pathways
Ethics and boundaries
Cultural sensitivity
Trauma and recovery
Community resources
Delivering peer services within organizations

(Virginia Law)

Certification Training Hours

Virginia’s regulations require an approved certifying body to require at least:

46 hours of training

across the state-defined peer recovery curriculum areas. (Virginia Law)

Virginia’s own DBHDS training is more extensive at:

72 hours.

The Virginia Certification Board states that its CPRS pathway uses the 72-hour DBHDS curriculum, which includes 46 hours specific to the formal peer recovery domains. (Virginia Certification Board)

CPRS Work Experience

The Virginia Certification Board requires:

500 hours of volunteer or paid peer recovery experience

specific to the peer recovery domains. (Virginia Certification Board)

Virginia’s regulations similarly require approved certifying bodies to require at least 500 hours of supervised peer recovery support experience within the three years before certification application. (Virginia Law)

These hours must involve nonclinical, recovery-oriented peer support activities.

CPRS Supervision Hours

The Virginia Certification Board requires:

25 hours of on-the-job supervision

of the qualifying peer recovery work experience. (Virginia Certification Board)

Organizations developing new Peer Recovery Specialists should therefore track:

Peer work hours
Supervision hours
Supervisor
Dates
Peer recovery domains addressed

Current Peer Job Description

VCB also requires CPRS applicants to submit a copy of their current Peer Recovery Specialist job description.

The job description must be signed by:

The applicant
The immediate supervisor

(Virginia Certification Board)

CPRS Examination

Virginia Certification Board CPRS applicants must pass the:

IC&RC Peer Recovery Specialist examination

after their certification application has been approved. (Virginia Certification Board)

This means completing Virginia’s training and work-experience requirements alone does not establish full CPRS certification.

Virginia Peer Recovery Specialist Code of Ethics

Virginia requires Peer Recovery Specialists to sign and abide by the Virginia Peer Recovery Specialist Code of Ethics. (Virginia Law)

Peer ethics may address issues such as:

Confidentiality
Appropriate use of lived experience
Boundaries
Participant autonomy
Professional conduct
Cultural responsiveness
Conflicts of interest
Recovery-oriented practice

Certification Bodies Recognized by Virginia

Virginia’s regulations allow qualifying Peer Recovery Specialist certification through:

U.S. Department of Veterans Affairs
NAADAC
An IC&RC member board
Another certifying body approved by DBHDS

(Virginia Law)

The Virginia Certification Board is Virginia’s IC&RC member board and awards the CPRS credential. (Virginia Certification Board)

DBHDS also publicly recognizes the National Certified Peer Recovery Support Specialist, or NCPRSS, pathway through NAADAC. (DBHDS)

How to Become a Virginia CPRS

Step 1: Meet the Education Requirement

Have a high school diploma, GED, or equivalent.

Step 2: Meet the Lived Experience Requirement

Meet the applicable recovery or family lived-experience requirements.

Step 3: Complete DBHDS PRS Training

Complete Virginia’s approved 72-hour Peer Recovery Specialist curriculum.

Step 4: Accumulate Peer Experience

Complete at least:

500 hours

of qualifying paid or volunteer peer recovery experience.

Step 5: Complete Supervision

Complete at least:

25 hours

of on-the-job supervision for the VCB CPRS credential.

Step 6: Submit the CPRS Application

Submit required materials, including the signed peer job description.

Step 7: Pass the IC&RC Examination

Successfully complete the Peer Recovery Specialist examination.

Step 8: Maintain Certification

Complete the required continuing education and recertify according to VCB requirements.

Step 9: Register With the Board of Counseling if Required

For Medicaid-reimbursable peer services, complete the Board of Counseling registration process to become an RPRS.

Board of Counseling Registration

Virginia has a separate regulatory registration process for Peer Recovery Specialists.

Applicants for registration must submit:

The Board of Counseling application
Applicable fee
Current National Practitioner Data Bank report
Evidence that DBHDS Peer Recovery Specialist requirements have been satisfied

(Virginia Law)

Where Registered Peer Recovery Specialists May Work

Virginia regulations state that an RPRS provides services as an employee or independent contractor of:

DBHDS
A provider licensed by DBHDS
A practitioner licensed by or holding a permit from the Department of Health Professions
A facility licensed by the Virginia Department of Health

(Virginia Law)

Organizations should verify whether additional program-specific provider requirements apply.

CPRS Recertification

Virginia Certification Board CPRS certification renews on a:

Two-year cycle.

Current VCB requirements specify:

20 hours of continuing education

relevant to peer recovery during each recertification period. (Virginia Certification Board)

Ethics Continuing Education

Of the 20 CPRS continuing education hours:

6 hours must address ethics. (Virginia Certification Board)

VCB lists qualifying ethics topics such as:

Professional ethics
HIPAA
Confidentiality
Boundaries
Mental health law
Mandated reporting

(Virginia Certification Board)

Online Continuing Education

VCB currently places:

No limit

on the number of CPRS recertification hours that may be completed online. (Virginia Certification Board)

Training may be:

In person
Online
Hybrid

(Virginia Certification Board)

Lapsed CPRS Credential

VCB permits recertification of a lapsed credential for up to:

12 months after expiration.

After more than 12 months, the professional must reapply and meet current certification requirements. (Virginia Certification Board)

Mental Health Peer Support

Virginia’s peer workforce includes people supporting recovery from mental illness.

Mental health peer support may include:

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

Peer services remain nonclinical even when delivered within licensed behavioral health programs. (Virginia Law)

Substance Use Peer Support

Virginia also has a substantial substance use recovery peer workforce.

Peer services may support people experiencing:

Opioid use disorder
Alcohol use disorder
Stimulant use disorder
Other substance use disorders
Co-occurring mental health conditions

Activities may include:

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

Co-Occurring Disorders

Virginia explicitly includes recovery from:

Mental illness
Addiction
Both

within its Peer Recovery Specialist framework. (Virginia Law)

This allows qualified peers to support people navigating co-occurring behavioral health needs.

Family Support Partners

Virginia Medicaid formally recognizes Family Support Partners.

Family Support Partners are a form of peer recovery support provided to the caregiver of a Medicaid-eligible person younger than 21 with:

Mental health disorder
Substance use disorder
Co-occurring mental health and substance use disorder

The service is intended to increase the family’s capacity to manage services and supports while improving recovery and healthy relationships. (Virginia Law)

Who Can Provide Family Support Partner Services?

Virginia’s Medicaid rules describe qualifying Family Support Partner services as being delivered by a PRS who is:

A parent of a minor or adult child with a similar behavioral health condition
Or an adult with personal experience supporting a family member with a similar condition and navigating behavioral health services

(Virginia Law)

The worker must provide services within the scope of their:

Knowledge
Lived experience
Education

Family Support Partner Purpose

Family Support Partners are designed to help caregivers:

Build confidence
Build capacity
Navigate systems
Develop supports
Promote recovery
Promote healthy family relationships
Manage complex service systems

The service must be directed toward the benefit of the Medicaid-eligible individual. (Virginia Law)

Virginia Medicaid Peer Support

Virginia Medicaid formally covers qualifying peer support services.

The Medicaid framework includes:

Mental health peer support
Addiction and Recovery Treatment Services, or ARTS, peer support
Family Support Partner services

Peer services must satisfy Virginia’s professional, provider, service authorization, medical necessity, supervision, documentation, and billing requirements. (Virginia Law)

Medicaid Registration Requirement

Virginia requires Peer Recovery Specialists delivering Medicaid-reimbursable services to register with the Virginia Board of Counseling.

Once registered, the professional is referred to as a:

Registered Peer Recovery Specialist

RPRS. (DBHDS)

Medicaid Service Authorization

Virginia Medicaid requires an approved:

Service authorization

before peer support or Family Support Partner services are delivered for reimbursement. (Virginia Law)

The provider must support the authorization request with information documented in the participant’s record.

Service Recommendation

Virginia Medicaid requires peer services to begin within:

30 calendar days

of the documented recommendation.

The recommendation itself is valid for no more than 30 calendar days. (Virginia Law)

Recovery, Resiliency, and Wellness Plan

Virginia defines a Recovery, Resiliency, and Wellness Plan as a set of:

Goals
Strategies
Actions

created by the person receiving services to guide recovery toward greater independence and autonomy. (Virginia Law)

Medicaid peer services must be based on:

Identified participant needs
Medical necessity
Goals in the Recovery, Resiliency, and Wellness Plan

(Virginia Law)

Medicaid Billing Unit

Virginia Medicaid defines one peer support unit as:

15 minutes. (Virginia Law)

Peer Recovery Specialists must document each 15-minute unit during which the participant was actively engaged in the service.

Medicaid Daily Service Limit

Virginia’s current Medicaid rules generally limit Peer Support Services and Family Support Partners to:

4 hours per calendar day

or:

16 units per day. (Virginia Law)

Limits may be exceeded when documented medical necessity exists and service authorization is approved.

Medicaid Annual Service Limit

Virginia’s current standard annual limit is:

900 hours per calendar year. (Virginia Law)

The rules establish separate annual limits for applicable mental health peer services and ARTS peer services.

Medicaid Group Services

Virginia Medicaid permits qualifying group peer services.

Current regulations limit group size to:

No more than 10 individuals per one PRS. (Virginia Law)

Each participant must have an individual progress note in their record.

Public Support Groups vs. Medicaid Peer Groups

Virginia explicitly states that general support groups available to the public for:

Education
Global advocacy

do not qualify as Medicaid Peer Support Services or Family Support Partners. (Virginia Law)

This is an important distinction between community recovery activity and reimbursable Medicaid services.

Noncovered Medicaid Peer Activities

Virginia Medicaid specifically excludes activities including:

Transportation
Documentation
Recordkeeping
Billing activities
Administrative paperwork
Services performed by volunteers
Household tasks
Chores
Grocery shopping
On-the-job training
Case management
Outreach to prospective participants
Room and board

from reimbursable Peer Support Services. (Virginia Law)

A peer may perform some of these activities in another role or funding structure, but they should not automatically be billed as Medicaid peer support.

Telephone Peer Support

Virginia’s current Medicaid regulations permit some telephone peer support but treat it as supplemental rather than a replacement for in-person contact.

Telephone services are generally limited to:

25% or less of total peer service time per participant per calendar year. (Virginia Law)

Telephone services must be justified and documented.

Providers should verify whether more recent program-specific telehealth rules modify this requirement before billing remote services.

Minimum Medicaid Contact

Virginia Medicaid requires contact with the participant receiving Peer Support Services or Family Support Partners at least:

Twice per month.

At least one contact must be face-to-face under the current regulation, while the second may be face-to-face or telephone based on documented needs and preferences. (Virginia Law)

Providers should verify whether current telehealth guidance creates any applicable exceptions.

Peer Supervision in Virginia Medicaid

Virginia Medicaid establishes detailed supervisor qualifications.

A direct supervisor may qualify through pathways including:

An experienced certified PRS with at least two consecutive years of peer-service experience and DBHDS supervisor training
A credentialed addiction treatment professional who has completed DBHDS PRS supervisor training
A qualifying Certified Substance Abuse Counselor operating under appropriate professional supervision and completing PRS supervisor training

(Virginia Law)

Supervision for New Peer Workers

For ARTS peer services, a PRS with fewer than:

12 months of experience

must receive face-to-face, one-to-one supervisory meetings for at least:

30 minutes twice each month. (Virginia Law)

The direct supervisor must also be available by telephone while the PRS is on duty.

Supervision After One Year

A PRS with:

More than 12 months
But fewer than 24 months

of ARTS peer experience must receive:

Monthly face-to-face individual supervision of at least 30 minutes. (Virginia Law)

The supervisor must be available for consultation within the applicable timeframe.

Organizations should verify the rules applicable to staff with more experience and to non-ARTS peer services.

Medicaid Caseload Limits

Virginia’s ARTS peer regulations establish maximum caseloads.

A full-time PRS may have no more than:

15 individuals

at one time.

A part-time PRS may have no more than:

9 individuals

at one time. (Virginia Law)

There is no minimum caseload requirement.

Medicaid Documentation

Virginia Medicaid requires documentation to substantiate peer services and billed units.

Documentation should establish:

Participant
Date
Start and stop time
Units
Recovery goal
Service provided
Participant engagement
Progress
Peer worker
Service authorization
Applicable collaboration
Follow-up

Each 15-minute unit must correspond to active engagement in Peer Support Services or Family Support Partner services. (Virginia Law)

Peer Records

Virginia Medicaid allows an organization to integrate peer documentation into the participant’s broader organizational record as long as peer support documentation remains:

Clearly identified. (Virginia Law)

Logs and progress notes must corroborate the services billed.

Collaboration With Behavioral Health Providers

Virginia Medicaid requires collaboration with behavioral health service providers.

This collaboration includes:

The PRS
The person receiving services or caregiver
Other behavioral health providers

and should address:

Initiation of peer services
Participant status
Changes in progress

Documentation of collaboration must be maintained in the participant’s record. (Virginia Law)

Documentation Should Be

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

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 only to justify reimbursement

Documentation and Billing Are Not the Same Thing

A completed peer note does not automatically mean the service is Medicaid reimbursable.

Payment may additionally depend on:

Medicaid eligibility
Peer certification
Board of Counseling registration
Enrolled provider status
Medical necessity
Assessment
Service recommendation
Service authorization
Recovery, Resiliency, and Wellness Plan
Supervisor qualification
Group size
Service limits
Correct billing configuration
Documentation
Timely claim submission

Organizations should validate each requirement separately.

Scope of Peer Support

Virginia Peer Recovery Specialists may appropriately support people through:

Sharing relevant lived experience
Recovery mentoring
Recovery education
Recovery planning
Wellness support
Self-advocacy
Advocacy
Community navigation
Treatment engagement
Natural support development
Goal setting
Coping support
Community integration
Recovery capital development
Family support
Group peer support

Activities Generally Outside Peer Scope

Unless separately licensed and authorized under another professional role, a PRS 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 modify clinical treatment
Make involuntary treatment decisions
Represent themselves as a licensed clinician
Provide legal advice

Virginia expressly defines peer recovery support as nonclinical. (Virginia Law)

Confidentiality

Virginia peer organizations may handle sensitive:

Mental health information
Substance use records
Recovery information
Family information
Medicaid information

Applicable requirements may include:

HIPAA
42 CFR Part 2
Virginia law
DBHDS requirements
DMAS requirements
Board of Counseling requirements
Organizational policy
Participant consent

Peer workers should receive role-specific training addressing:

Documentation
Confidentiality
Participant authorization
Substance use records
Care-team collaboration
Text messaging
Email
Remote services
Social media
Crisis communication

Starting a Peer Support Program in Virginia

Step 1: Define the Population

Determine whether the organization serves:

Adults with mental health conditions
Adults with substance use disorders
People with co-occurring conditions
Families and caregivers
Young adults
Medicaid members
Community recovery populations
Other behavioral health populations

Step 2: Determine the Peer Qualification

Determine whether workers need to function as:

PRS
CPRS
NCPRSS
RPRS
Family Support Partner

depending on the program and payer.

Step 3: Complete Virginia Peer Training

Ensure workers complete the applicable 72-hour DBHDS PRS curriculum.

Step 4: Build Certification Tracking

For Virginia Certification Board CPRSs, track:

High school diploma/GED
Lived-experience eligibility
72-hour training
500 peer work hours
25 supervision hours
Signed job description
IC&RC examination
CPRS certification
Expiration
Continuing education
Six ethics hours
Recertification

Step 5: Complete Board Registration Where Required

For Medicaid peer services, track:

Board of Counseling registration
RPRS status
NPDB report
Registration renewal
Certification status

Step 6: Establish Peer Supervision

Determine:

Direct supervisor
Supervisor qualification
DBHDS supervisor training
Required supervision frequency
Documentation
Availability
Crisis escalation

Step 7: Determine the Funding Model

Potential public funding structures may include:

Virginia Medicaid
Medicaid managed care
DBHDS programs
Community Services Boards
State and federal behavioral health grants
Recovery programs
Other public or private contracts

Step 8: Configure Medicaid Requirements

Where applicable, track:

Eligibility
Assessment
Service recommendation
Service authorization
Recovery, Resiliency, and Wellness Plan
RPRS
Supervisor
15-minute units
Daily limits
Annual limits
Group ratio
Telephone utilization
Claims

Step 9: Separate Community and Medicaid Peer Work

Virginia explicitly excludes general public support groups from Medicaid Peer Support Services. (Virginia Law)

Organizations should therefore distinguish:

Community peer support
Mutual aid
Volunteer peer services
Grant-funded peer work
Medicaid-reimbursable PRS services

Step 10: Measure Outcomes

Potential outcomes include:

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

Common Challenges for Virginia Peer Programs

PRS vs. CPRS vs. RPRS

Virginia uses several related terms.

They are not identical:

PRS refers to the professional peer role.

CPRS refers to an approved peer certification.

RPRS refers to a qualified PRS registered with the Virginia Board of Counseling.

Organizations should track these separately.

72-Hour Training vs. Certification Requirements

Virginia’s official PRS curriculum is 72 hours, while regulations require approved certifying bodies to include at least 46 hours across required peer domains. (Virginia Law)

For the Virginia Certification Board pathway, the full DBHDS 72-hour curriculum is required. (Virginia Certification Board)

Certification vs. Medicaid Registration

A CPRS credential alone is not the same as RPRS status.

Board of Counseling registration is required for Medicaid-reimbursable Peer Recovery Specialist services. (DBHDS)

Family Support Partners

Virginia recognizes family lived experience within both the broader PRS framework and Medicaid Family Support Partner services.

Programs should distinguish:

Person receiving Medicaid
Caregiver receiving support
PRS
Family relationship
Recovery goals

Service Authorization

Virginia Medicaid requires service authorization before reimbursable peer service delivery. (Virginia Law)

Organizations need reliable authorization tracking before scheduling or billing.

Medicaid Service Limits

Programs must monitor:

16 units per day
900 hours per year
Group ratios
Telephone-service percentages

under the applicable rules. (Virginia Law)

Caseload Limits

Applicable ARTS peer programs also need to account for:

15-person maximum full-time caseload
9-person maximum part-time caseload

(Virginia Law)

Supervision Requirements

Virginia’s Medicaid rules vary supervision requirements based partly on peer experience.

Organizations should know:

How long each peer has provided applicable services
Who supervises them
Whether the supervisor completed DBHDS supervisor training
Whether required meetings occurred

Community Support vs. Medicaid PSS

Public support groups, volunteer services, transportation, outreach, and other meaningful recovery activities may not qualify as Medicaid Peer Support Services. (Virginia Law)

Organizations need funding-aware workflows.

Documentation Burden

Virginia Medicaid requires detailed unit-level documentation.

Programs need enough structure to support compliance while preserving the nonclinical and relationship-based nature of peer work.

Role Drift

Peers may gradually become responsible for:

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

Organizations should preserve Virginia’s formal distinction between peer recovery support and clinical services.

Frequently Asked Questions

What is a Peer Recovery Specialist in Virginia?

A PRS is a person professionally qualified through education and experience to provide collaborative services supporting sustained recovery from mental illness, addiction, or both. (Virginia Law)

What is a CPRS?

A Certified Peer Recovery Specialist is a peer professional who has obtained an approved certification, including the Virginia Certification Board credential.

What is an RPRS?

A Registered Peer Recovery Specialist is a qualified Peer Recovery Specialist registered with the Virginia Board of Counseling. (Virginia Law)

Who manages Virginia’s PRS training?

The Virginia Department of Behavioral Health and Developmental Services. (DBHDS)

How long is Virginia PRS training?

72 hours. (DBHDS)

Is a high school diploma required?

Yes.

Virginia requires a high school diploma or equivalent. (Virginia Law)

How much recovery experience is required?

Virginia’s minimum standards for approved certifying bodies require at least one year of recovery for applicable lived-experience pathways. (Virginia Law)

How much peer work experience does VCB require?

500 hours of qualifying paid or volunteer peer recovery experience. (Virginia Certification Board)

How much supervision does VCB require?

25 hours of on-the-job supervision. (Virginia Certification Board)

Is an examination required?

Yes.

VCB applicants must pass the IC&RC Peer Recovery Specialist examination. (Virginia Certification Board)

How often does CPRS certification renew?

Every two years under current VCB requirements. (Virginia Certification Board)

How much continuing education is required?

20 hours, including 6 hours of ethics. (Virginia Certification Board)

Can continuing education be completed online?

Yes.

VCB currently places no limit on the number of online recertification hours. (Virginia Certification Board)

Does Virginia Medicaid cover Peer Support Services?

Yes. (Virginia Law)

Must a Medicaid peer be registered?

Yes.

DBHDS states that approved certified peer specialists must register with the Board of Counseling for Medicaid billing. (DBHDS)

Does Medicaid require service authorization?

Yes. (Virginia Law)

What is the Medicaid billing unit?

15 minutes. (Virginia Law)

What is the standard daily limit?

4 hours or 16 units per calendar day, subject to approved exceptions based on medical necessity. (Virginia Law)

What is the standard annual limit?

900 hours per calendar year, subject to applicable rules and authorized exceptions. (Virginia Law)

How large can a Medicaid peer group be?

No more than 10 individuals per PRS under the current regulation. (Virginia Law)

Does Medicaid reimburse public recovery support groups?

Not simply because they are peer-led.

Virginia states that general support groups available to the public for education or global advocacy do not qualify as Medicaid Peer Support Services. (Virginia Law)

Is transportation Medicaid-billable as Peer Support Services?

No.

Transportation is specifically listed as a noncovered peer support activity under the cited Medicaid regulation. (Virginia Law)

Is writing a progress note billable peer-service time?

No.

Documentation and recordkeeping are specifically excluded from reimbursable peer service activity. (Virginia Law)

Does Virginia Medicaid cover Family Support Partners?

Yes.

Family Support Partners provide qualifying peer services to caregivers of eligible individuals younger than 21. (Virginia Law)

Can family lived experience qualify someone as a PRS?

Yes, under applicable circumstances and when all other professional requirements are met. (Virginia Law)

Are Virginia Peer Recovery Specialists clinicians?

No.

Virginia formally defines peer recovery support services as nonclinical. (Virginia Law)

Official Virginia Peer Support Resources

Virginia DBHDS Recovery Support

Official Virginia Department of Behavioral Health and Developmental Services resource covering Peer Recovery Specialists, CPRS, RPRS, certification pathways, registration, practice resources, and recovery support.