II 

118TH CONGRESS 

1ST SESSION S. 3498 

To amend title XVIII of the Social Security Act to provide for coverage 

of peer support services under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 13, 2023 

Ms. CORTEZ MASTO (for herself and Mr. CASSIDY) introduced the following 

bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for coverage of peer support services under the Medicare 

program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Promoting Effective 

5 and Empowering Recovery Services in Medicare Act of 

6 2023’’ or the ‘‘PEERS Act of 2023’’. 

7 SEC. 2. COVERAGE OF PEER SUPPORT SERVICES UNDER 

8 THE MEDICARE PROGRAM. 

9 (a) COVERAGE.—Section 1861 of the Social Security 

10 Act (42 U.S.C. 1395x) is amended— 

2 

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1 (1) in subsection (s)(2)— 

2 (A) in subparagraph (JJ), by inserting 

3 ‘‘and’’ after the semicolon at the end; and 

4 (B) by adding at the end the following new 

5 subparagraph: 

6 ‘‘(KK) peer support services (as defined in sub7 section (nnn)) furnished on or after January 1, 

8 2025;’’; and 

9 (2) by adding at the end the following new sub10 section: 

11 ‘‘(nnn) PEER SUPPORT SERVICES.— 

12 ‘‘(1) PEER SUPPORT SERVICES.—The term 

13 ‘peer support services’ means emotional, informa14 tional, instrumental, and affiliational support serv15 ices— 

16 ‘‘(A) furnished— 

17 ‘‘(i) by a Federally qualified health 

18 center, a rural health clinic, a community 

19 mental health center, or a certified commu20 nity behavioral health clinic (as described 

21 in section 223 of the Protecting Access to 

22 Medicare Act of 2014), using a peer sup23 port specialist; and 

24 ‘‘(ii) to an individual who has been di25 agnosed with— 

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1 ‘‘(I) a mental disorder; or 

2 ‘‘(II) a substance use disorder; 

3 and 

4 ‘‘(B) that are designed to assist such indi5 vidual in achieving recovery, integration in the 

6 community, self-empowerment, and self-deter7 mination (as specified by the Secretary). 

8 ‘‘(2) PEER SUPPORT SPECIALIST.—The term 

9 ‘peer support specialist’ means an individual who— 

10 ‘‘(A) is recovering from a mental health or 

11 substance use condition; and 

12 ‘‘(B) is certified as qualified to furnish 

13 peer support services under a certification proc14 ess consistent with the National Practice Guide15 lines for Peer Supporters and inclusive of the 

16 Substance Abuse and Mental Health Services 

17 Administration Core Competencies for Peer 

18 Workers in Behavioral Health Settings (as es19 tablished by the State in which such individual 

20 furnishes such services or under such certifi21 cation process determined appropriate by the 

22 Secretary of Health and Human Services.’’. 

23 (b) PAYMENT.— 

24 (1) COMMUNITY MENTAL HEALTH CENTERS

25 AND CERTIFIED COMMUNITY BEHAVIORAL HEALTH

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•S 3498 IS

1 CLINICS.—Section 1833(a)(1) of the Social Security 

2 Act (42 U.S.C. 1395l(a)(1)) is amended— 

3 (A) by striking ‘‘and’’ before ‘‘(HH)’’; and 

4 (B) by inserting before the semicolon: ‘‘, 

5 and (II) with respect to peer support services 

6 (as defined in section 1861(nnn)) furnished by 

7 a community mental health center or a certified 

8 community behavioral health clinic, the amount 

9 paid shall be an amount equal to 80 percent of 

10 the lesser of the actual charge for the services 

11 or the amount determined by a fee schedule es12 tablished by the Secretary for the purposes of 

13 this subparagraph’’. 

14 (2) INCLUSION AS RHC AND FQHC SERVICES.— 

15 Section 1861(aa)(1)(B) of the Social Security Act 

16 (42 U.S.C. 1395x(aa)(1)(B)) is amended— 

17 (A) by striking ‘‘or by a mental’’ and in18 serting ‘‘by a mental’’; and 

19 (B) by inserting ‘‘or when using a peer 

20 support specialist,’’ after ‘‘subsection (ll)(4)),’’. 

21 (c) EXCLUSION MODIFICATION.—Section 1862(a)(1) 

22 of the Social Security Act (42 U.S.C. 1395y(a)(1)) is 

23 amended— 

24 (1) in subparagraph (O), by striking ‘‘and’’ at 

25 the end; 

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1 (2) in subparagraph (P), by striking the semi2 colon at the end and inserting ‘‘, and’’; and 

3 (3) by adding at the end the following new sub4 paragraph: 

5 ‘‘(Q) in the case of peer support services (as de6 fined in section 1861(nnn)), which are not furnished 

7 by a rural health clinic, a Federally qualified health 

8 center, a community mental health center, or a cer9 tified community behavioral health clinic;’’. 

Æ