What service provided by Certified Peer Counselors (CPCs) may be reimbursable under Medicaid?

Medically necessary peer support provided by Certified Peer Counselors (CPCs) may be reimbursable under Medicaid because it directly aligns with the services that Medicaid recognizes as essential for promoting recovery and wellness. The role of a CPC is to use their lived experience to help individuals navigate their mental health or substance use challenges, fostering a supportive relationship that encourages self-advocacy and empowerment.

Medicaid is designed to cover services that are deemed medically necessary for the treatment of mental health and substance use disorders, which includes peer support services led by individuals who have undergone specific training. These services are considered integral to the recovery process, as they provide individuals with the tools and support they need to manage their conditions effectively.

The other options, while important forms of assistance, often fall outside the scope of what Medicaid typically covers as reimbursable services. For example, substance abuse counseling might not qualify if provided by someone without a specific license or credential. Psychological evaluations often require licensed professionals and may not be considered peer-based support. Family therapy services also typically need to be conducted by licensed therapists. Therefore, the support offered by CPCs is distinctive in its focus on shared experience and altruistic support, aligning well with Medicaid's goals for patient support and recovery.