What does PIN — Peer Support pay in 2026?
| Code | What it covers | CY2026 national non-facility |
|---|---|---|
| G0140 | first 60 min / month, peer-support specialist | $89.18 |
| G0146 | each added 30 min, max 4 units | $53.44 |
National averages from our verified CY2026 fee-schedule config (source: CMS Physician Fee Schedule). Actual payment varies by locality, payer, and site of service.
Who can bill it?
Physicians, NP/PA practitioners, and behavioral-health clinicians for behavioral-health conditions within their scope.
Certified peer-support specialists furnish the time under general supervision — certification per the applicable state requirements is the qualifying credential.
One practitioner bills PIN-PS for the patient's condition in a given month, with the practice's personnel attestation on file.
What are the minute thresholds?
- 60 minutes of peer-support time in the calendar month opens G0140.
- Each added 30 minutes bills a G0146 unit, capped at 4 units (current NCCI MUE).
- Minutes count once, tied to the documented behavioral-health condition.
What has to be in place first?
- A qualifying behavioral condition
- A serious, high-risk behavioral-health condition — the peer-support lane is behavioral by design.
- A certified peer-support specialist
- The furnishing workforce must hold peer-support certification meeting the applicable requirements; the practice attests to this before billing.
- Consent and enrollment with condition documentation
- Documented consent, program enrollment, and the qualifying condition recorded — the same per-condition scoping as PIN.
What gets claims denied?
- Uncertified furnishing staff
- Peer support without the certification isn't PIN-PS — the credential is the code's premise, and the attestation is a billing condition.
- Commercial payers that never adopted it
- Medicare-first 2024 codes; CO-181-class denials from payers that haven't loaded them.
- Add-on units past the cap
- More than 4 G0146 units exceeds the NCCI MUE.
- Duplicate condition claims
- Like PIN, the scope is per condition — a second practitioner claiming the same condition-month duplicates and denies.
What could this look like for your panel?
Estimates only, not billing advice. Actual Medicare reimbursement varies by region, payer, and year. Figures approximate CY2026 national non-facility averages from our verified fee-schedule config.
Frequently asked questions
- What makes PIN-PS different from PIN?
- The workforce. PIN uses trained navigators; PIN-PS uses certified peer-support specialists, whose lived recovery experience is the qualification — for behavioral-health conditions specifically.
- Who certifies a peer-support specialist?
- Certification follows the applicable state and program requirements; the billing practice attests that its peer-support staff meet them before the first claim.
- Can a counselor's practice bill PIN-PS?
- Yes — behavioral-health clinicians can be the billing practitioner for behavioral-health conditions within their scope, with certified peers furnishing the time.
- Is peer-support time reimbursable outside this code?
- PIN-PS is Medicare's first direct lane for peer support tied to a treatment plan. Outside it, peer time typically rides state Medicaid programs — a different system with different rules.
This page is general information, not billing, coding, or legal advice. Verify current requirements with the relevant payer before billing. Mallowa helps practices capture and document coordination time and generates claim-ready superbills; it does not submit claims or determine eligibility.