Washington State Peer Support & Medicaid Guide

Washington is in the middle of a major transition in how peer support professionals are credentialed and reimbursed.

Historically, Washington relied heavily on the Certified Peer Counselor, or CPC, model. Beginning July 1, 2025, the state implemented a new Department of Health credentialing framework for:

Certified Peer Support Specialist, or CPSS
Certified Peer Support Specialist Trainee, or CPSST

The new credentials are governed by Chapter 18.420 RCW and Chapter 246-929 WAC. Beginning January 1, 2027, the Certified Peer Support Specialist profession will supersede Certified Peer Counselors for Medicaid-reimbursable peer services. (Washington State Legislative Website)

Washington’s peer training is administered by the Washington State Health Care Authority, or HCA. The current training pathway includes an 80-hour Peer Support Specialist training, state examination, and additional supervised experience before full CPSS certification through the Washington State Department of Health. (Washington State Department of Health)

Washington Peer Support Quick Facts

Category	Washington overview
State Medicaid program	Apple Health
State Medicaid agency	Washington State Health Care Authority
Peer credential	Certified Peer Support Specialist
Abbreviation	CPSS
Trainee credential	Certified Peer Support Specialist Trainee
Abbreviation	CPSST
Credentialing agency	Washington State Department of Health
Training agency	Washington State Health Care Authority
Minimum age	18
Lived experience	Required
Recovery requirement	1+ year
Family lived-experience pathway	Yes
CPSS training	80 hours
Examination	Included in HCA training process
Supervised experience	1,000 hours
Certification renewal	Every 2 years
Continuing education	30 hours every 2 years
Peer-specific CE	At least 14 hours
Law and ethics CE	At least 2 hours
Suicide prevention	3 hours every 6 years
Health equity	2 hours every 4 years
Telehealth training	1 hour before telehealth practice
Medicaid peer support	Yes
CPC Medicaid transition ends	December 31, 2026
CPSS-only Medicaid transition	January 1, 2027
Last reviewed	August 2026

What Is Peer Support in Washington?

Washington defines peer support as support provided through shared lived experience to help another person acquire and use skills supporting recovery.

Current state rules identify activities including:

Accessing treatment
Engaging in treatment
Symptom management
Social connection
Recovery
Self-advocacy
Developing natural community supports
Improving daily living skills
Working toward health and wellness goals
Connecting people with resources
Supporting people outside traditional office settings

(Washington State Legislative Website)

Peer support is specifically nonclinical.

Washington rules state that Certified Peer Support Specialists and trainees:

Are not clinical providers
May not assess or diagnose mental health conditions
May not assess or diagnose substance use disorders
May not provide mental health counseling
May not provide substance use disorder counseling

They may help participants connect with clinical behavioral health providers when the participant wants that support. (Washington State Legislative Website)

Certified Peer Support Specialist

The Certified Peer Support Specialist, or CPSS, is Washington’s new formal peer credential.

The Washington State Department of Health began issuing the credential under the new Chapter 18.420 RCW framework effective July 1, 2025. (LawFiles)

The credential is voluntary for general peer practice.

Washington rules specifically state that a person may provide peer counseling or peer support services without obtaining the CPSS credential.

However, the titles:

Certified Peer Support Specialist
Certified Peer Support Specialist Trainee

are protected and may only be used by people holding the applicable active credential. (Washington State Legislative Website)

Certified Peer Support Specialist Trainee

Washington also recognizes the Certified Peer Support Specialist Trainee, or CPSST.

The trainee credential allows a person who has completed the required education and examination process to accumulate the supervised experience required for full CPSS certification.

Trainees must renew their certification annually.

Unlike fully certified CPSS professionals, trainees currently have no continuing education requirement for renewal. (Washington State Department of Health)

Lived Experience Requirement

Applicants must attest that they identify as either:

A person with one or more years in recovery from a mental health condition, substance use disorder, or both
The parent or legal guardian of a youth who is receiving or has received behavioral health services

(Washington State Department of Health)

Washington therefore recognizes both:

Personal recovery lived experience
Family behavioral health lived experience

within its peer credentialing framework.

Minimum Age

Applicants for Washington’s Peer Support Specialist training must be at least:

18 years old. (Washington State Legislative Website)

Recovery Requirement

For the personal lived-experience pathway, Washington requires:

One or more years in recovery

from:

A mental health condition
Substance use disorder
Or both

(Washington State Department of Health)

Family Peer Pathway

Washington’s certification framework also allows a person to qualify based on being:

The parent or legal guardian of a youth who is receiving or has received behavioral health services. (Washington State Department of Health)

This means Washington integrates family lived experience within the broader CPSS credentialing structure rather than necessarily requiring a completely separate family peer credential for every setting.

80-Hour Peer Support Specialist Training

Applicants using the traditional Washington pathway must complete the Health Care Authority’s:

80-hour Peer Support Specialist training. (Washington State Department of Health)

HCA is the state’s official training provider for Peer Support Specialists.

The training pathway includes:

Online prerequisite material
80-hour CPSS training
State examination

(Washington State Health Care Authority)

Online Prerequisite Training

Washington requires prospective Peer Support Specialists to complete an online prerequisite course before the formal training and testing process.

HCA notes that the examination covers information from both:

The online prerequisite course
The 80-hour training

(Washington State Health Care Authority)

CPSS Examination

Washington includes written and oral examinations within the Peer Support Specialist training process.

Applicants must successfully complete:

The HCA-approved CPSS training
The state CPSS oral examination
The state CPSS written examination

(Washington State Health Care Authority)

After passing, HCA provides documentation showing that the individual has met the educational requirements needed to apply to DOH as either:

CPSS
CPSST

(Washington State Legislative Website)

Former 40-Hour Certified Peer Counselor Training

Washington previously relied on a 40-hour Certified Peer Counselor training.

People who completed the former 40-hour CPC training do not necessarily need to repeat the entire 80-hour course.

Current DOH requirements allow these individuals to complete the HCA Gap Training for Peers to satisfy the new educational standards. (Washington State Department of Health)

Out-of-State Applicants

Applicants with qualifying out-of-state peer credentials may need to complete:

HCA Gap Training
Washington Peer Specialist prerequisite training

before qualifying under Washington’s current framework. (Washington State Department of Health)

Washington also recognizes certain national certifications.

Applicants holding an acceptable active national certification may satisfy the state’s education and experience requirements. (Washington State Department of Health)

Supervised Experience

Full CPSS certification generally requires:

1,000 hours of supervised experience

as a Certified Peer Support Specialist Trainee. (Washington State Department of Health)

The experience must be completed under an approved supervisor.

The hours do not have to be consecutive.

Experience Before July 1, 2025

Washington provides transition pathways for people who gained qualifying peer experience before the new credential became effective.

Examples include:

1,000 hours working as a peer counselor after completing HCA peer training
One year working as an Agency Affiliated Counselor peer counselor

when properly verified by an employer or approved behavioral health provider. (Washington State Department of Health)

Approved Supervisors

Washington requires supervised CPSS trainee experience to occur under an approved supervisor.

The state also requires specific supervision training for approved supervisors.

DOH identifies the Health Care Authority as the provider of Washington’s Supervision of Peer Specialists training. (Washington State Department of Health)

Approved supervisors have additional continuing education requirements.

CPSS Certification Renewal

Certified Peer Support Specialists renew their credential:

Every two years

on or before their birthday. (Washington State Department of Health)

Because initial credentials may be issued for less than two years to align with the person’s birthday, the first complete continuing education cycle may begin after the first renewal.

Continuing Education

Washington currently requires:

30 hours of continuing education every two years. (Washington State Department of Health)

The required categories include:

At least 14 hours of peer-specific courses
At least 2 hours of law and ethics
Up to 14 additional hours involving counseling, coaching, professional development, or employer-sponsored training

(Washington State Department of Health)

Suicide Prevention Training

Certified Peer Support Specialists must complete:

3 hours of suicide prevention training

including screening and referral.

The training must be repeated:

Once every six years. (Washington State Department of Health)

Health Equity Training

Washington CPSS professionals must complete:

2 hours of health equity training every four years. (Washington State Department of Health)

Supervisor Continuing Education

Approved supervisors must complete:

6 hours of supervision education every two years. (Washington State Department of Health)

Organizations should therefore track supervisor credentials separately from frontline peer credentials.

Telehealth Training

Any Washington provider offering telehealth services must complete:

One hour of telehealth training

before providing telehealth services. (Washington State Department of Health)

This applies to Peer Support Specialists providing qualifying remote services.

Background Checks

Washington DOH processes a background check for each credential applicant.

Some applicants may also need:

Washington State Patrol checks
FBI fingerprint-based background checks

depending on the circumstances of the application. (Washington State Department of Health)

CPSS Application Fee

The current DOH fee schedule lists:

$100

for Certified Peer Support Specialist application and certification.

Current renewal is also:

$100. (Washington State Department of Health)

CPSST Fees

Current Washington rules list:

for the Certified Peer Support Specialist Trainee application and annual renewal. (Washington State Department of Health)

This lowers the financial barrier for people entering the supervised workforce-development stage.

Washington’s Transition From CPC to CPSS

Washington’s Medicaid peer infrastructure is currently transitioning from the older:

Certified Peer Counselor

model to the newer:

Certified Peer Support Specialist

profession.

Certified Peer Counselors may continue providing Medicaid-reimbursable peer services through:

December 31, 2026

when all applicable requirements are satisfied. (Washington State Legislative Website)

Beginning:

January 1, 2027

the CPSS profession will supersede Certified Peer Counselors for Medicaid-reimbursable peer services.

On and after that date, only:

Certified Peer Support Specialists
Certified Peer Support Specialist Trainees

may provide Medicaid-reimbursable peer services under the applicable rules. (Washington State Legislative Website)

Certified Peer Counselor During the Transition

Through December 31, 2026, a Certified Peer Counselor may provide Medicaid-reimbursable peer services only when requirements include:

Clinical supervision by an appropriate mental health professional, substance use disorder professional, or both
Services through a licensed community behavioral health agency
Credentialing as an Agency Affiliated Counselor

(Washington State Legislative Website)

Organizations employing CPCs should therefore prepare for the 2027 credential transition.

Apple Health and Peer Support

Washington Medicaid is known as Apple Health.

Washington HCA states directly that:

Peer counseling is an approved Medicaid service. (Washington State Health Care Authority)

The service pairs people in recovery with trained individuals or parents who have relevant shared lived experience.

Medicaid and CPSS Credentialing

HCA states that the DOH CPSS credential is particularly relevant for people who:

Work at licensed behavioral health agencies
Want their services to be Medicaid billable
Supervise CPSS trainees

(Washington State Health Care Authority)

This is important because the CPSS credential itself is voluntary for general peer practice, while Medicaid reimbursement has more specific credential requirements.

Certification and Billing Are Different

Holding a CPSS credential does not automatically make every peer interaction Medicaid reimbursable.

Organizations should separately verify:

Active peer credential
Provider organization eligibility
Apple Health enrollment
Participant eligibility
Covered service
Program requirements
Supervision
Documentation
Managed care requirements
Claim requirements

Mental Health Peer Support

Washington’s CPSS credential covers lived experience involving mental health conditions.

Mental health peer services may include:

Recovery mentoring
Wellness planning
Self-advocacy
Treatment engagement
Social connection
Community integration
Natural support development
Daily living skills
Resource navigation
Recovery education

Washington rules explicitly recognize activities involving symptom management and treatment engagement while preserving the nonclinical nature of the peer role. (Washington State Legislative Website)

Substance Use Peer Support

Washington also includes substance use recovery within its CPSS credential.

Substance use peer services may support:

Recovery planning
Treatment engagement
Recovery capital
Mutual support
Resource navigation
Housing resources
Employment resources
Natural supports
Wellness
Community connection
Self-advocacy

The Peer Support Specialist does not provide substance use counseling unless separately licensed to do so under another professional credential. (Washington State Legislative Website)

Co-Occurring Behavioral Health Needs

Washington’s lived-experience pathway explicitly includes:

Mental health conditions
Substance use disorders
Both

This allows Peer Support Specialists to support people navigating co-occurring behavioral health needs. (Washington State Department of Health)

Family Peer Support

Washington’s credentialing framework also recognizes:

Parents or legal guardians of youth who are receiving or have received behavioral health services. (Washington State Department of Health)

Family peer services may include:

Behavioral health navigation
Parent mentoring
Advocacy
Education
Resource connection
Family empowerment
Self-advocacy
Natural support development

Organizations should verify specific Medicaid and program requirements for family peer services.

Crisis Peer Support

Washington provides specialized training for peers working in crisis response.

The Health Care Authority provides Crisis Awareness and Communication in Peer Support, or CACPS, training for Peer Support Specialists working in crisis response. (Washington State Department of Health)

Organizations operating crisis programs should track this specialty training separately from basic CPSS certification.

Scope of Practice

Washington’s CPSS scope includes peer interventions using shared experience to help participants develop skills supporting recovery.

Publicly defined activities include:

Treatment access
Treatment engagement
Symptom-management support
Social connection
Recovery
Self-advocacy
Natural community supports
Daily living skills
Health and wellness goals
Community-based engagement
Resource connection

(Washington State Legislative Website)

Activities Outside Peer Scope

Washington specifically states that CPSS professionals and trainees are not clinical providers.

They may not:

Diagnose mental health conditions
Diagnose substance use disorders
Conduct mental health counseling
Conduct substance use disorder counseling
Provide clinical services solely under the peer credential

(Washington State Legislative Website)

Unless separately licensed, peers should also not:

Prescribe medication
Provide psychotherapy
Provide medical advice
Conduct licensed clinical assessments
Independently modify clinical treatment plans

Peer Support Outside an Office

Washington explicitly recognizes that Peer Support Specialist interventions may occur:

Outside an office or agency setting. (Washington State Legislative Website)

This supports community-based peer work involving:

Resource navigation
Community integration
Recovery activities
Natural support development
Engagement in everyday environments

Peer services are therefore not limited to conventional behavioral health offices.

Documentation for Washington Peer Support

A strong Washington peer support note may include:

Participant identifier
Date
Start and end time
Duration
Location
Modality
Peer worker
Credential
Trainee status where applicable
Recovery or wellness goal
Peer intervention
Relevant use of lived experience
Treatment engagement support
Self-advocacy
Resource navigation
Natural support development
Participant response
Progress
Barriers
Follow-up
Signature or attestation

Specific Apple Health documentation requirements should be verified through the current Medicaid billing guidance for the applicable service and provider setting.

Documentation Should Be

Accurate
Timely
Person-centered
Recovery-oriented
Strengths-based
Nonclinical
Specific
Respectful
Relevant
Connected to participant 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
Documentation of services that did not occur
Personal opinions presented as clinical facts
Documentation written solely to justify reimbursement

Confidentiality

Washington peer programs may handle sensitive:

Mental health information
Substance use information
Recovery information
Family information

Applicable requirements may include:

HIPAA
42 CFR Part 2
Washington law
Apple Health requirements
DOH requirements
HCA requirements
Organizational policies
Participant consent

Peer workers should receive role-specific training addressing:

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

Starting a Peer Support Program in Washington

Step 1: Define the Population

Determine whether the program serves:

Adults with mental health conditions
People with substance use disorders
People with co-occurring behavioral health needs
Youth
Parents and caregivers
Crisis populations
Community recovery populations
Apple Health members
Other behavioral health populations

Step 2: Determine the Peer Credential

Identify whether staff need:

Certified Peer Support Specialist
Certified Peer Support Specialist Trainee
Transitional Certified Peer Counselor status through 2026
Crisis specialty training

Step 3: Verify Lived-Experience Eligibility

Confirm whether the worker qualifies through:

Personal recovery
Parent/legal guardian lived experience

Step 4: Complete HCA Training

Track completion of:

Online prerequisite
80-hour CPSS training
Oral examination
Written examination

Step 5: Apply for DOH Credential

After HCA confirms completion of the educational requirements, apply for the appropriate DOH credential.

Step 6: Track Supervised Experience

For trainees working toward full certification, track:

1,000 required hours
Approved supervisor
Dates
Work setting
Experience verification

Step 7: Track Continuing Education

For fully certified workers, track:

30 total CE hours
14 peer-specific hours
2 law and ethics hours
Suicide prevention training
Health equity training
Telehealth training where applicable

Step 8: Prepare for the 2027 Medicaid Transition

Organizations employing Certified Peer Counselors should prepare for the transition effective:

January 1, 2027

when CPSS and CPSST credentials become the applicable peer professions for Medicaid reimbursement. (Washington State Legislative Website)

Step 9: Establish Supervision

Determine:

Approved supervisor
Supervisor training
Supervision schedule
Documentation
Crisis consultation
Professional development

Step 10: Measure Outcomes

Potential outcomes include:

Engagement
Recovery goal progress
Treatment engagement
Self-advocacy
Social connection
Natural supports
Community integration
Wellness
Housing
Employment
Crisis utilization
Participant satisfaction
Peer workforce retention
Credential progression
Documentation timeliness

Common Challenges for Washington Peer Programs

Major Credential Transition

Washington’s peer workforce is shifting from Certified Peer Counselor to Certified Peer Support Specialist.

Organizations need to understand the difference between:

CPC
CPSST
CPSS

and the Medicaid transition date of January 1, 2027. (Washington State Legislative Website)

Voluntary Credential vs. Medicaid Requirement

The CPSS credential is voluntary for general peer practice in Washington.

However, Medicaid-reimbursable peer services operate under more specific credential requirements. (Washington State Legislative Website)

Organizations should not confuse title protection with Medicaid provider qualification.

80-Hour Training Transition

Older peers may have completed Washington’s former:

40-hour Certified Peer Counselor training.

Those workers may need the current Gap Training rather than repeating the entire 80-hour program. (Washington State Department of Health)

1,000-Hour Experience Requirement

The new CPSS credential requires substantial supervised practice.

Organizations should track trainee experience continuously rather than trying to reconstruct 1,000 hours at the end of the process.

Continuing Education Categories

Washington requires 30 hours but divides those hours across several categories.

Systems should separately track:

Peer-specific CE
Law and ethics
Suicide prevention
Health equity
Supervisor CE

Telehealth Training

Peer workers must complete required telehealth training before providing telehealth services. (Washington State Department of Health)

Crisis Training

Peers working in crisis response may need CACPS training in addition to their core credential. (Washington State Department of Health)

Family Lived Experience

Washington recognizes parent/legal guardian experience within its CPSS eligibility framework.

Programs should be able to identify whether the peer’s qualification pathway involves:

Personal recovery
Family lived experience

without unnecessarily collecting detailed personal health information.

Documentation Burden

Peer support is relationship-based and nonclinical.

Documentation should support accountability and Medicaid requirements without making peers document as though they are therapists.

Role Drift

Washington’s rules specifically reinforce that peer specialists are not clinical providers.

Organizations should avoid gradually assigning peers:

Diagnostic responsibilities
Counseling responsibilities
Clinical assessments
Other licensed clinical tasks

Frequently Asked Questions

What is Washington’s current peer credential?

The Certified Peer Support Specialist, or CPSS. (Washington State Department of Health)

Does Washington have a trainee credential?

Yes.

Washington has a Certified Peer Support Specialist Trainee, or CPSST, credential. (Washington State Department of Health)

Who issues the credential?

The Washington State Department of Health.

Who provides the training?

The Washington State Health Care Authority. (Washington State Department of Health)

How old must a Peer Support Specialist be?

At least 18 years old. (Washington State Legislative Website)

Is lived experience required?

Yes.

Applicants must qualify through personal recovery or the parent/legal guardian pathway. (Washington State Department of Health)

How much recovery time is required?

For the personal lived-experience pathway, at least one year of recovery. (Washington State Department of Health)

How long is the current Washington peer training?

80 hours. (Washington State Department of Health)

Is there an examination?

Yes.

The HCA training process includes written and oral state examinations. (Washington State Health Care Authority)

What if someone completed the old 40-hour CPC training?

They may complete HCA Gap Training to satisfy the new education requirements. (Washington State Department of Health)

Is suicide prevention training required?

Yes.

Three hours every six years. (Washington State Department of Health)

Is health equity training required?

Yes.

Two hours every four years. (Washington State Department of Health)

Is telehealth training required?

Yes.

A one-hour telehealth training must be completed before providing telehealth services. (Washington State Department of Health)

Does Apple Health cover peer support?

Yes.

Washington HCA identifies peer counseling as an approved Medicaid service. (Washington State Health Care Authority)

Can Certified Peer Counselors still bill Medicaid?

During the transition, yes, when applicable requirements are satisfied.

The CPC Medicaid pathway remains available through December 31, 2026. (Washington State Legislative Website)

What happens January 1, 2027?

The Certified Peer Support Specialist profession supersedes the Certified Peer Counselor profession for Medicaid-reimbursable peer services.

After that date, only qualifying CPSS and CPSST professionals may provide Medicaid-reimbursable peer services under the applicable rules. (Washington State Legislative Website)

Is CPSS certification required to provide any peer support in Washington?

No.

Washington specifically states that peer workers are not required to obtain the certification simply to provide peer services.

However, the CPSS and CPSST titles are protected. (Washington State Legislative Website)

Can CPSS professionals diagnose mental health conditions?

No. (Washington State Legislative Website)

Can they provide mental health counseling?

No, not on the basis of the peer credential alone. (Washington State Legislative Website)

Can they provide substance use counseling?

No, not on the basis of the peer credential alone. (Washington State Legislative Website)

Can peers work outside a behavioral health office?

Yes.

Washington rules explicitly recognize peer interventions occurring outside office or agency settings. (Washington State Legislative Website)

Official Washington Peer Support Resources

Washington Peer Support Specialist Certification

Official Washington State Department of Health resource covering CPSS and CPSST applications, renewal, continuing education, fees, background checks, and credentialing.