PEERS Act of 2025
- Sponsor
- Rep. Chu, Judy [D-CA-28]
- Committees
- Ways and Means Committee (primary)
- Last action
- Dec 18, 2025
Bottom line
The bill expands Medicare coverage to include peer support services for individuals with mental health or substance use conditions, aiming to enhance recovery and community integration through a federally recognized framework.
What it actually does
This bill amends Title XVIII of the Social Security Act, which governs Medicare, to include peer support services as a covered benefit. It specifies that these services, provided by certified peer support specialists, will be reimbursable when furnished by community mental health centers, rural health clinics, Federally qualified health centers, and certified community behavioral health clinics. The bill also establishes formal definitions for 'peer support services' and 'peer support specialist' within the Medicare statute.
Proponents argue
Supporters argue that peer support services are a cost-effective and evidence-based approach to mental health and substance use disorder recovery, leveraging lived experience to provide empathy and practical guidance. Including these services in Medicare would significantly increase access for beneficiaries who often face significant barriers to care, promoting better health outcomes, fostering community integration, and potentially reducing reliance on more intensive, expensive interventions.
Opponents contend
Critics might express concerns about the potential cost implications of expanding Medicare benefits, especially without a clear CBO score outlining the financial impact on the Medicare Trust Funds. They might also raise questions about the standardization and quality control of peer support specialist certification across different states, or whether these services are truly distinct from existing covered therapies and how they will be integrated without duplication.
The bill is very short and easy to read, allowing ample time for a thorough understanding of its provisions and implications.
Section 2(a)(1)
Medicare Coverage for Peer Support in Community Mental Health Centers
This provision amends the Social Security Act to explicitly include "peer support services" as a covered service when provided by a community mental health center (CMHC) under the Medicare program. This change broadens the scope of services CMHCs can offer and be reimbursed for, allowing them to integrate peer-led recovery support into their existing mental health care offerings.
Supporters argue
Supporters argue this expands access to a crucial recovery modality within established mental health care settings, leveraging existing infrastructure to deliver peer support effectively to those in need.
Critics contend
Some might argue that adding new services to CMHCs without clear, dedicated funding mechanisms could strain existing resources or lead to increased costs for the Medicare program without a proportional increase in overall system efficiency.
Tradeoffs
This provision balances the desire to expand access to recovery services with potential administrative and financial implications for CMHCs and the Medicare system.
Section 2(a)(2)
Medicare Coverage for Peer Support in Rural Health Clinics and Federally Qualified Health Centers
This provision amends the Social Security Act to allow peer support specialists to furnish services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). It modifies existing language to include services provided "by a peer support specialist" alongside other mental health professionals, ensuring these facilities can also offer and be reimbursed for peer support services, particularly important for underserved populations.
Section 2(b)
Defining Peer Support Services and Peer Support Specialist
This section adds a new subsection to the Social Security Act, formally defining "peer support services" and "peer support specialist." Peer support services are defined as emotional, informational, instrumental, and social/community support provided by a peer support specialist at specified facilities to individuals with mental health or substance use conditions, aimed at recovery and self-determination. A "peer support specialist" is defined as an individual in recovery, certified under a state process consistent with national guidelines (e.g., SAMHSA Core Competencies).
This provision amends Section 1862(a)(1) of the Social Security Act, which lists services excluded from Medicare coverage. It adds a new subparagraph (Q) to clarify that peer support services are *not* excluded from coverage if they are furnished by a rural health clinic, a Federally qualified health center, a community mental health center, or a certified community behavioral health clinic.
Section 2(c)
Why it matters:This is standard legislative practice to ensure legal precision. When a new service is introduced, it's often necessary to explicitly carve out exceptions from general exclusion categories to prevent ambiguity and ensure the intended coverage takes effect. It is a technical clarification rather than an attempt to obscure a policy.
Case for: This technical amendment is crucial for ensuring legal clarity and preventing future disputes over whether peer support services, even when provided by the intended facilities, could be deemed non-covered under other general exclusions. It solidifies the bill's intent.
Case against: No specific opposition is typically raised against technical clarifications that align with the bill's primary intent, as it serves to remove ambiguity rather than introduce new policy.
Estimated impact: Clarifies the scope of covered services, providing legal certainty for both Medicare beneficiaries seeking peer support and for the healthcare providers offering these services, potentially preventing denials of care or reimbursement issues.