N.M. Admin. Code § 8.321.2.42

Current through Register Vol. 36, No. 1, January 14, 2025

Section 8.321.2.42 - PEER SUPPORT SERVICES

Peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders.

A.Eligible practitioners: Must be self-identified consumers who are in recovery from mental illness or substance use disorder. In addition to the requirements of Subsections A and B of 8.321.2.9 NMAC, in order to be eligible to be reimbursed for providing peer support services practitioners meet the following qualifications:

(1) Certified peer support workers (CPSW) must:

(a) complete the certification program offered through BHSD;

(b) be certified by the NM credentialing board for behavioral health professionals;

(c) complete 20 hours of initial training and 20 hours of education every subsequent year;

(d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and

(e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals.

(2) Certified family peer support workers (CFPSW) must:

(a) complete the certification program offered through CYFD;

(b) be certified by the NM credentialing board for behavioral health professionals;

(c) complete 20 hours of initial training and 20 hours of education every subsequent year;

(d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and

(e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals.

(3) Certified youth peer support specialists (CYPSS) must:

(a) complete the certification program offered through CYFD;

(b) be certified by the NM credentialing board for behavioral health professionals;

(c) complete 20 hours of initial training and 20 hours of education every subsequent year;

(d) be supervised by an independent practitioner or someone trained and certified to supervise peers; and

(e) services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals.

B.Non-covered services: Peer support services are subject to the limitations and coverage restrictions that exist for other MAD covered services. See Subsection G of 8.321.2.9 NMAC for general non-covered specialized behavioral health services.

C.Reimbursement: peer support providers must submit claims for reimbursement on the CMS-1500 claim form or its successor. See Subsection E of 8.321.2.9 NMAC for MAD general reimbursement requirements and 8.302.2 NMAC. Once enrolled, the peer support provider receives instructions on how to access documentation, billing, and claims processing information.

N.M. Admin. Code § 8.321.2.42

Adopted by New Mexico Register, Volume XXXV, Issue 23, December 10, 2024, eff. 12/10/2024