Medicare to Cover Peer Mental Health Support Starting 2027, But Only at Specific Clinics

The PEERS Act of 2025 is tackling a huge gap in Medicare coverage by adding peer support services to the list of covered benefits. If you know someone dealing with mental health issues or substance use disorder, this is a big deal. Instead of relying solely on clinical staff, this bill authorizes Medicare to pay for support provided by people who have actually been there—individuals in recovery themselves.

The Friend Who Gets It: What’s Covered

Starting January 1, 2027, Medicare beneficiaries diagnosed with a mental health condition or substance use disorder will have access to these services. The bill defines “peer support services” as emotional, informational, instrumental, and social support designed to help people achieve recovery, community integration, and self-empowerment (Section 1861(nnn)). Essentially, it’s about providing non-clinical, lived-experience support that helps people navigate the real-world challenges of recovery, like finding housing or getting back into the workforce.

Crucially, the bill defines a “peer support specialist” as someone recovering from a mental health or substance use condition who is certified according to national guidelines (Section 1861(nnn)). This formalizes the role and ensures that the people providing this support have both the personal experience and the required training to be effective. This is a win for the recovery community, finally bringing a reimbursement stream to a service that has proven incredibly valuable.

The Catch: Where You Can Get Help

While this is a major expansion, there’s a significant restriction baked into the bill. Medicare will only pay for these peer support services if they are furnished by four specific types of facilities: community mental health centers, rural health clinics, Federally qualified health centers (FQHCs), or certified community behavioral health clinics (Section 1862(a)(1)).

Think of it this way: If you’re a Medicare beneficiary in a major city and your favorite peer specialist works for a small, independent non-profit not affiliated with an FQHC, Medicare won’t cover that service. This restriction is likely meant to ensure quality control and organizational oversight, but it could limit access, especially for people who rely on independent specialists or organizations not structured as one of the four mandated facility types. For someone in a geographically isolated area, if the closest FQHC is already overwhelmed, this limitation could create a bottleneck rather than easing access.

Real-World Impact and Implementation

For the millions of Medicare recipients struggling with behavioral health issues, this bill offers a pathway to support that often feels more relatable and less intimidating than traditional therapy. For example, an older adult dealing with chronic pain and opioid use disorder could receive support from a peer specialist who helps them navigate local support groups and reconnect with their community, rather than just focusing on clinical treatment.

However, the two-year lead time until the January 1, 2027, effective date is necessary. Facilities need time to hire and integrate certified peer specialists, and states need to ensure their certification processes align with the required national guidelines. The quality of this expansion will ultimately hinge on how well these facilities can scale up their peer workforce while maintaining the integrity and authenticity that makes peer support so effective.