Washington, DC Peer Support & Medicaid Guide

Washington, DC has a formal peer support infrastructure spanning mental health, substance use recovery, family support, youth peer services, community behavioral health, Medicaid-funded services, recovery support services, and specialized peer roles.

The District’s primary peer credential is the Certified Peer Specialist, commonly abbreviated CPS.

The District of Columbia Department of Behavioral Health, or DBH, administers the Peer Specialist Certification Training Program. DBH describes Peer Specialists as self-identified people who have been successful in the recovery process and use their experience to support people with similar experiences involving mental health and/or substance use disorders. (Department of Behavioral Health)

The District also recognizes specialty peer designations, including:

Certified Peer Specialist - Family
Certified Peer Specialist - Youth
Certified Peer Specialist - Recovery

District regulations allow DBH to establish additional specialty designations based on identified workforce needs. (Department of Behavioral Health)

DC Medicaid also reimburses qualifying peer support services. Current Medicaid materials identify H0038 for individual Self-Help/Peer Support, H0038 HQ for group peer support, and additional configurations for family peer services. (DC Medicaid)

Washington, DC Peer Support Quick Facts

Category	Washington, DC overview
Medicaid program	DC Medicaid
Behavioral health authority	DC Department of Behavioral Health
Abbreviation	DBH
Primary peer credential	Certified Peer Specialist
Abbreviation	CPS
Minimum age	18
District residency	Required for standard 2026 training pathway
Education	High school diploma, GED, or higher
Lived experience	Required
Recovery requirement	2 years or longer
Field practicum	80 hours
Certification examination	Required
Passing examination score	85%
Certification period	2 years
Continuing education	20 CEUs per 2 years
Family specialty	Yes
Youth specialty	Yes
Recovery/SUD specialty	Yes
Waiver pathway	Yes
Medicaid peer support	Yes
Individual Medicaid code	H0038
Group peer code	H0038 HQ
Family peer service	H0038 HS
Medicaid unit	15 minutes
Recovery Support Services	Medicaid billable
Last reviewed	August 2026

What Is Peer Support in Washington, DC?

DBH describes Peer Specialists as people who use their own recovery experiences to support others with similar behavioral health experiences.

Through mutual respect and shared understanding, peers may help people:

Enter treatment
Navigate the behavioral health system
Identify community resources
Make informed recovery choices
Sustain recovery
Advocate for themselves
Develop wellness goals
Connect with supports

DBH describes the peer role as adding a distinct consumer perspective to person-centered behavioral health care. (Department of Behavioral Health)

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

Certified Peer Specialist

The Certified Peer Specialist, or CPS, is Washington, DC’s primary formal peer credential.

District regulations define a Certified Peer Specialist as someone who has successfully completed the District’s Peer Specialist Certification Program and is authorized to deliver peer support within the public behavioral health system. (Department of Behavioral Health)

Certified Peer Specialists may work in roles involving:

Mentoring
Recovery support
Resource navigation
Advocacy
Treatment-team participation
Recovery groups
Community engagement
Participant satisfaction activities
Program and policy input

DBH publicly identifies all of these as examples of how Certified Peer Specialists contribute to the behavioral health system. (Department of Behavioral Health)

CPS Eligibility

DBH’s current 2026 training requirements identify several basic eligibility criteria.

Applicants must:

Be District residents
Be at least 18 years old
Have a high school diploma, GED, or higher
Be self-identified current or former consumers of behavioral health services
Be in recovery from a mental illness and/or substance use disorder for at least two years

(Department of Behavioral Health)

Lived Experience Requirement

Lived experience is foundational to the District’s peer credential.

DBH’s training is intended for people who have personal experience with behavioral health recovery and can use that experience to support others diagnosed with:

Mental illness
Substance use disorder
Or both

(Department of Behavioral Health)

The District therefore treats lived experience as a formal qualification, not simply a preferred background.

Recovery Requirement

Current DBH eligibility requirements specify that applicants must have been in recovery from:

Mental illness
Substance use disorder
Or both

for:

Two years or longer. (Department of Behavioral Health)

Education Requirement

Applicants must have at least:

A high school diploma
GED
Or higher education

(Department of Behavioral Health)

A college degree is not required.

Age Requirement

Applicants must be at least:

18 years old. (Department of Behavioral Health)

District Residency

For the standard 2026 DBH Peer Specialist Certification Training Program, applicants must be:

District of Columbia residents. (Department of Behavioral Health)

Applicants pursuing waiver testing should review the separate waiver eligibility standards.

Peer Specialist Certification Training

DBH operates the Peer Specialist Certification Training Program.

The program provides the core curriculum and instruction necessary to obtain DBH Peer Specialist Certification.

DBH states that the curriculum is based on foundational competencies consistent with national peer-support standards and builds on the participant’s personal recovery experience. (Department of Behavioral Health)

The current 2026 program is delivered through multiweek training sessions followed by a field practicum and certification examination. (Department of Behavioral Health)

Field Practicum

After successfully completing the classroom portion of training, participants must complete an:

80-hour field practicum

with a behavioral health provider certified by DBH. (Department of Behavioral Health)

The practicum allows participants to apply peer-support competencies within the District’s behavioral health system.

Organizations developing peer workers should separately track:

Classroom completion
Practicum placement
Practicum hours
Supervising organization
Completion date

Certification Examination

Peer Specialist applicants must pass a certification examination.

District regulations state that applicants must achieve at least:

85%

to pass the examination. (Department of Behavioral Health)

If a participant does not pass, the District allows another attempt within the applicable timeframe.

A participant who does not pass after two attempts may apply to repeat additional classroom or practicum work before testing again. (Department of Behavioral Health)

Requirements for Certification

Before DBH awards the Certified Peer Specialist credential, the Department verifies that the applicant has:

Successfully completed required classroom work
Successfully completed the field practicum
Passed the certification examination
Signed the Peer Specialist Code of Ethics

(Department of Behavioral Health)

Certification Period

Washington, DC Certified Peer Specialist certification is valid for:

Two years from the date of issuance. (Department of Behavioral Health)

Organizations should therefore track:

Certification date
Expiration date
Continuing education
Specialty designation
Recertification status

Continuing Education

Certified Peer Specialists must complete at least:

20 continuing education units during each two-year certification period. (Department of Behavioral Health)

DBH maintains approved education opportunities related to:

Mental health
Recovery
Peer support
Related behavioral health topics

Other courses may qualify with prior approval from the appropriate DBH office. (Department of Behavioral Health)

Certified Peer Specialist Specialty Designations

Washington, DC regulations authorize DBH to create specialty designations for Certified Peer Specialists.

Current regulations specifically identify:

Certified Peer Specialist - Family
Certified Peer Specialist - Youth
Certified Peer Specialist - Recovery

(Department of Behavioral Health)

Specialty designations require completion of:

The core Certified Peer Specialist program
Additional specialty training
Any additional requirements established by DBH

Certified Peer Specialist - Family

The Certified Peer Specialist - Family designation is intended for someone who:

Is or has been the parent or legal guardian of a child or youth receiving mental health services
Can provide peer support to children or youth and their parents or legal guardians currently receiving mental health services

(Department of Behavioral Health)

Family peers may support caregivers with:

Behavioral health navigation
Advocacy
Education
Service coordination
Family empowerment
Community resources
Understanding child-serving systems

Certified Peer Specialist - Youth

The Certified Peer Specialist - Youth designation is intended for an individual who:

Received mental health services before age 22
Can support children or youth currently receiving mental health services

(Department of Behavioral Health)

Youth peer support may include:

Self-advocacy
Behavioral health navigation
Recovery
Education
Transition support
Community connection
Goal development
Youth voice

Certified Peer Specialist - Recovery

The Certified Peer Specialist - Recovery specialty is designed for people with:

A history of substance use

who can provide peer support to people currently receiving substance use services. (Department of Behavioral Health)

Recovery-focused peer services may include:

Recovery mentoring
Recovery planning
Treatment engagement
Community resources
Mutual support
Recovery capital development
Housing resources
Employment resources
Recovery maintenance
Wellness support

Additional Specialty Development

DBH may establish other peer specialties based on system needs.

The District’s FY26-27 behavioral health planning materials identify ongoing development of specialized peer roles involving populations such as:

Youth
Families
Justice-involved individuals
People with co-occurring disorders

The plan also identifies continued peer workforce development, supervision education, career pathways, and potential peer-led crisis and drop-in programs. (Department of Behavioral Health)

These initiatives are planning priorities rather than necessarily fully implemented statewide programs, so organizations should verify current status with DBH.

Certification Waiver Pathway

Washington, DC provides a waiver-testing pathway for experienced peer workers and qualifying individuals with outside certification.

Current 2026 DBH requirements allow waiver consideration for applicants who are:

At least 18
High school graduates, GED holders, or higher
In behavioral health recovery for at least two years
Currently or formerly employed or volunteering in a peer role within the DC behavioral health system or its contractors for at least five years

or who:

Hold current peer certification from another state or jurisdiction in good standing

(Department of Behavioral Health)

What the Waiver Does

The waiver process may allow qualifying applicants to demonstrate their knowledge through testing rather than completing every component of the standard training pathway.

Applicants should review current DBH waiver requirements because eligibility, documentation, and examination procedures may change.

Mental Health Peer Support

Mental health peer support is a longstanding component of the District’s public behavioral health system.

Peer services may include:

Recovery mentoring
Wellness support
Treatment engagement
Self-advocacy
Community integration
Coping support
Natural support development
Recovery groups
Resource navigation
Goal development

The District’s peer certification framework originally developed around mental health consumer peer support and has since expanded to encompass broader behavioral health recovery. (Department of Behavioral Health)

Substance Use Peer Support

DBH’s current certification program includes people in recovery from substance use disorders. (Department of Behavioral Health)

The District also formally recognizes the Certified Peer Specialist - Recovery specialty for individuals with substance use lived experience. (Department of Behavioral Health)

Substance use peer support may include:

Recovery coaching
Treatment engagement
Recovery planning
Resource navigation
Community connection
Recovery groups
Self-advocacy
Recovery capital development
Long-term recovery support

Co-Occurring Disorders

DBH’s Peer Specialist Certification Training Program serves people with lived experience involving:

Mental health
Substance use
Both

The District’s FY26-27 behavioral health plan also identifies people with co-occurring conditions as a population for specialized peer workforce development. (Department of Behavioral Health)

Recovery Support Services

Washington, DC also operates a formal Recovery Support Services, or RSS, infrastructure for people with substance use disorders.

DBH’s current behavioral health planning materials state that RSS services are Medicaid billable and include:

Recovery Support Evaluation
Recovery Support Individual
Recovery Support Group

The same planning materials state that many recovery supports can be delivered by Certified Peer Specialists. (Department of Behavioral Health)

Recovery Support Organizations

The District’s substance use recovery system includes providers certified to deliver Recovery Support Services.

People seeking SUD recovery services generally must be appropriately assessed and admitted to a qualifying:

SUD treatment provider
Recovery Support Services provider

under the public behavioral health framework. (Department of Behavioral Health)

Organizations should distinguish formal RSS from broader community-based peer activity.

DC Medicaid Peer Support

DC Medicaid formally reimburses qualifying peer support services.

Current District Medicaid billing materials identify several H0038 service configurations.

These include:

Service	Code / Modifier
Individual Self-Help/Peer Support	H0038
Group Self-Help/Peer Support	H0038 HQ
Family Peer Support	H0038 HS
Family Group Peer Support	H0038 HQ HS

Current Medicaid billing materials classify H0038 as:

Self-help/peer services, per 15 minutes. (DC Medicaid)

Medicaid Billing Unit

The standard Medicaid peer support unit is:

15 minutes. (DC Medicaid)

Organizations should accurately capture:

Start time
End time
Duration
Units
Participant
Peer worker
Individual or group status
Family-service status where applicable
Documentation supporting the service

Individual Peer Support

Current Medicaid billing materials identify:

H0038

for individual Self-Help/Peer Support. (DC Medicaid)

The exact reimbursement rate can vary according to provider configuration and the applicable fee schedule.

Providers should verify the current DC Medicaid fee schedule rather than relying on an older published rate.

Group Peer Support

DC Medicaid also recognizes:

H0038 HQ

for group Self-Help/Peer Support. (DC Medicaid)

Organizations should clearly distinguish group encounters from individual services before claims are generated.

Family Peer Support

Current Medicaid billing materials identify:

H0038 HS

for Self-Help/Peer Support Family Service. (DC Medicaid)

The District also identifies:

H0038 HQ HS

for Family Group Peer Support. (DC Medicaid)

This aligns with the District’s broader formal recognition of family peer roles.

Medicaid Rates

DC Medicaid’s current provider fee schedule lists H0038 as a 15-minute service and includes current rates by provider configuration. (DC Medicaid)

Because DC Medicaid rates may change and can vary by provider and modifier configuration, organizations should use the current fee schedule directly for:

Financial modeling
Claims configuration
Contract review

rather than treating a rate quoted in this guide as permanent.

Peer Support Within Community Support

DC Medicaid has historically included peer support within its broader Mental Health Rehabilitative Services structure.

Public billing materials identify peer configurations alongside services such as:

Community Support
Medication Training and Support
Crisis services
Day services
Assertive Community Treatment

(DC Medicaid)

Peer support should still remain distinct in purpose and scope from clinical and generic case-management services.

Certified Peer Specialists in the Behavioral Health Network

DBH encourages certified behavioral health providers to employ Certified Peer Specialists.

Public DBH materials describe peer specialists participating in treatment teams under supervision while contributing a unique recovery and lived-experience perspective. (Department of Behavioral Health)

Peer specialists may work alongside:

Clinicians
Care coordinators
Substance use professionals
Community support workers
Other behavioral health staff

without becoming clinicians themselves.

Scope of Peer Support

Depending on specialty, program, and payer requirements, DC Certified Peer Specialists may appropriately support people through:

Sharing relevant lived experience
Recovery mentoring
Recovery education
Self-advocacy
Advocacy
Behavioral health navigation
Community resource navigation
Recovery planning
Wellness support
Goal development
Natural support development
Treatment engagement
Recovery groups
Community engagement
Family support
Youth support
Substance use recovery support

Activities Generally Outside Peer Scope

Unless separately licensed and authorized under another professional role, a Certified Peer Specialist generally should not:

Diagnose mental health conditions
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
Determine Medicaid eligibility
Provide legal advice

The Certified Peer Specialist credential is a peer support credential, not professional clinical licensure.

Peer Supervision

DBH publicly describes Certified Peer Specialists as participating in treatment teams under the supervision of a trained behavioral health professional. (Department of Behavioral Health)

Peer-focused supervision may address:

Use of lived experience
Recovery orientation
Ethics
Boundaries
Role fidelity
Documentation
Difficult participant interactions
Community resources
Crisis escalation
Professional development
Staff wellness

DBH’s current strategic planning also identifies provider education on peer supervision and understanding the peer role as an ongoing workforce priority. (Department of Behavioral Health)

Peer Specialist Code of Ethics

Applicants must sign the District’s Peer Specialist Code of Ethics before certification is issued. (Department of Behavioral Health)

Ethical peer practice may involve:

Confidentiality
Appropriate use of lived experience
Professional boundaries
Participant autonomy
Recovery orientation
Cultural responsiveness
Conflicts of interest
Respect
Professional conduct

Documentation for Washington, DC Peer Support

A strong peer support note may include:

Participant identifier
Date
Start time
End time
Duration
Location or modality
Certified Peer Specialist
Specialty designation where applicable
Recovery or wellness goal
Peer activity
Relevant use of lived experience
Mentoring
Advocacy
Resource navigation
Recovery education
Community connection
Participant response
Progress
Barriers
Follow-up
Signature or attestation

For Medicaid services, documentation should also support:

H0038
Applicable modifier
Individual vs. group status
Family status where applicable
15-minute units
Applicable provider requirements

Documentation Should Be

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

Documentation Should Avoid

Unsupported diagnoses
Clinical interpretations outside peer scope
Stigmatizing terminology
Generic statements such as “provided peer support”
Copy-and-paste documentation
Unnecessary sensitive information
Services that did not occur
Personal opinions presented as clinical facts
Documentation created solely to maximize reimbursement

Documentation and Billing Are Not the Same Thing

A completed peer note does not automatically establish that a Medicaid claim is payable.

Payment may additionally depend on:

DC Medicaid eligibility
Provider enrollment
DBH provider certification
Active CPS qualification
Covered service
Authorization where applicable
Service plan requirements
Correct procedure code
Correct modifier
Units
Documentation
Timely filing

Organizations should validate these requirements separately.

Confidentiality

Washington, DC peer programs may handle sensitive:

Mental health information
Substance use information
Recovery information
Family information
Youth information
Justice-related information

Applicable requirements may include:

HIPAA
42 CFR Part 2
District law
DBH requirements
DC Medicaid requirements
Organizational policies
Participant consent

Peer workers should receive role-specific training addressing:

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

Starting a Peer Support Program in Washington, DC

Step 1: Define the Population

Determine whether the program serves:

Adults with mental health conditions
People with substance use disorders
People with co-occurring conditions
Families
Youth
Justice-involved populations
Community recovery populations
Medicaid members
Other behavioral health populations

Step 2: Determine the Peer Role

Determine whether staff need:

Certified Peer Specialist
CPS - Family
CPS - Youth
CPS - Recovery
Another DBH specialty designation

Step 3: Verify Certification Requirements

Track current requirements involving:

District residency where applicable
Age
Education
Two-year recovery requirement
Classroom training
80-hour practicum
Certification examination
Code of Ethics
Certification expiration

Step 4: Build Credential Tracking

Track:

Training completion
Practicum hours
Examination status
Examination score
CPS certification
Specialty designation
Issue date
Expiration
20 CEUs
Recertification

Step 5: Determine Organizational Requirements

If the organization plans to provide Medicaid or DBH-funded behavioral health services, verify applicable:

DBH certification
DC Medicaid enrollment
Service authorization
Provider requirements
Contract requirements

Step 6: Determine Funding

Potential public funding pathways include:

DC Medicaid
DBH-funded behavioral health programs
Recovery Support Services
Federal behavioral health grants
Other public contracts

Step 7: Configure Medicaid Peer Services

Where applicable, systems should support:

H0038
HQ
HS
15-minute units
Individual services
Group services
Family services
Family group services
Participant eligibility
Documentation
Claim submission

Step 8: Build the Service Workflow

Map:

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

Step 9: Separate Medicaid and Community Peer Work

Not every meaningful peer interaction necessarily qualifies as Medicaid-billable H0038 activity.

Organizations should distinguish:

Medicaid peer services
Recovery Support Services
Community engagement
Public support groups
Grant-funded peer work
Other recovery activity

according to the applicable funding requirements.

Step 10: Measure Outcomes

Potential outcomes include:

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

Common Challenges for Washington, DC Peer Programs

Core Certification vs. Specialty Designations

The District has one core Certified Peer Specialist credential but allows specialty designations including:

Family
Youth
Recovery

Organizations should track both the core credential and any specialty designation.

Standard Training vs. Waiver Testing

Experienced peer workers and qualifying people with outside certification may use the waiver pathway.

Organizations should know whether the employee became certified through:

Standard DBH training
Waiver testing

while ensuring the active District credential remains current.

80-Hour Practicum

Completion of classroom training alone is not enough.

The standard pathway includes an 80-hour field practicum before certification. (Department of Behavioral Health)

Examination Requirement

Applicants must pass the certification examination at:

85% or higher. (Department of Behavioral Health)

Continuing Education

CPS professionals need 20 CEUs during each two-year certification period. (Department of Behavioral Health)

Programs should track CE continuously rather than waiting until expiration.

Mental Health vs. Recovery Peer Roles

The District’s core CPS infrastructure spans mental health and substance use, while the Recovery specialty and RSS infrastructure create additional substance-use-specific pathways.

Organizations should identify which service and credential configuration applies.

Medicaid Modifiers

DC Medicaid currently distinguishes among:

Individual peer support
Group peer support
Family peer support
Family group peer support

through H0038 modifier configurations. (DC Medicaid)

Documentation Burden

Peer support is relationship-based and rooted in lived experience.

Documentation should support accountability and reimbursement without forcing peers to write as if they were therapists.

Role Drift

Certified Peer Specialists may work within multidisciplinary behavioral health teams.

Organizations should preserve the distinct peer role and avoid gradually assigning:

Clinical assessment
Psychotherapy
Generic case management
Administrative duties
Other work outside peer scope

Frequently Asked Questions

What is Washington, DC’s primary peer credential?

The Certified Peer Specialist, or CPS. (Department of Behavioral Health)

Who administers certification?

The District of Columbia Department of Behavioral Health.

Is lived experience required?

Yes.

The program is designed for self-identified current or former behavioral health consumers who can support others with similar experiences. (Department of Behavioral Health)

How much recovery time is required?

Current DBH training eligibility requires at least:

Two years of recovery. (Department of Behavioral Health)

How old must an applicant be?

At least:

18 years old. (Department of Behavioral Health)

Is a high school diploma required?

Applicants must have a:

High school diploma
GED
Or higher education

(Department of Behavioral Health)

Is DC residency required?

For the standard 2026 training program, yes. (Department of Behavioral Health)

Is there a field practicum?

Yes.

The standard pathway requires an:

80-hour field practicum. (Department of Behavioral Health)

Is there an examination?

Yes.

What score is required?

At least:

85%. (Department of Behavioral Health)

How long is certification valid?

Two years. (Department of Behavioral Health)

How much continuing education is required?

20 CEUs every two years. (Department of Behavioral Health)

Does DC have a family peer specialty?

Yes.

The District recognizes Certified Peer Specialist - Family. (Department of Behavioral Health)

Does DC have a youth peer specialty?

Yes.

The District recognizes Certified Peer Specialist - Youth. (Department of Behavioral Health)

Does DC have a substance use recovery specialty?

Yes.

The District recognizes Certified Peer Specialist - Recovery. (Department of Behavioral Health)

Can someone with another state’s peer credential use a waiver pathway?

Potentially.

Current 2026 DBH guidance allows waiver consideration for applicants with current peer certification from another state or jurisdiction in good standing. (Department of Behavioral Health)

Does DC Medicaid cover peer support?

Yes.

Current Medicaid materials include H0038 peer support services. (DC Medicaid)

What is the individual Medicaid peer code?

H0038. (DC Medicaid)

What is the group peer code?

H0038 HQ. (DC Medicaid)

Does DC Medicaid recognize family peer support?

Yes.

Current billing materials identify H0038 HS for family peer service and H0038 HQ HS for family group peer service. (DC Medicaid)

What is the Medicaid billing unit?

15 minutes. (DC Medicaid)

Are Recovery Support Services Medicaid billable?

Yes.

Current DBH planning materials state that RSS services including evaluation, individual, and group recovery supports are Medicaid billable. (Department of Behavioral Health)

Are Certified Peer Specialists clinicians?

No.

The CPS credential itself is a peer support credential rather than a clinical professional license.

Official Washington, DC Peer Support Resources

DC Peer Specialist Certification Program

Official DBH resource covering current Peer Specialist Certification training, eligibility, field practicum, waiver testing, schedules, and certification.