Resources for Peer Recovery Support Services

Wisconsin Medicaid will begin covering peer recovery support (PRS) services on April 1, 2026. ForwardHealth will reimburse two types of agencies providing PRS services:

• Agencies certified under Wis. Admin. Code chs. DHS 34, 35, 36, 63, 72, 75, or 124 that provide peer services consistent with Wis. Admin. Code ch. DHS 72, subchapter II.
• Overdose treatment provider agencies certified under Wis. Admin. Code ch. DHS 72.

Provider Trainings

PRS services provider trainings will be available no later than April 1, 2026. These trainings include:

• PRS Services Overview
• Agency Requirements for PRS Services
• Staff Requirements for PRS Services
• New Overdose Treatment Provider Agency Enrollment
• PRS Services Claims Submission
• Adding PRS Services to Existing Benefits

Office of the Inspector General Trainings

The Office of the Inspector General (OIG) is responsible for helping ensure the integrity of the Wisconsin Department of Health Services (DHS)-administered public assistance programs, such as Wisconsin Medicaid. Providers can refer to the following self-paced trainings to learn more about program requirements:

• Module 1: Office of the Inspector General Overview
• Module 2: Provider Fraud, Waste, and Abuse in the Wisconsin Medicaid Program
• Module 3: Wisconsin Medicaid Enrollment Tips for Providers
• Module 4: Wisconsin Medicaid Self-Audit Tips for Providers
• Module 5: Verifying Wisconsin Medicaid Services

Payment Integrity Review Resources

Policy and Enrollment Resources

• Refer to the Peer Recovery Support Services service area of the Online Handbook for policy information. (Available after April 1, 2026.)
• Find enrollment information for overdose treatment provider agencies under the Overdose Treatment drop-down menu under Mental Health/Substance Abuse Agencies on the Information for Specific Provider Types provider enrollment page. (Available after April 1, 2026.)
• Contact Provider Services at 800-947-9627 for additional enrollment, policy, and billing questions.
• Field representatives can also help with complex billing and claims processing questions. Find more information about field representatives in the Professional Field Representatives topic #473.

Office of the Inspector General Resources

• Find more information about audits on the OIG Post-Payment Review page of the ForwardHealth Portal (the Portal).
• Learn more about the OIG on the Office of the Inspector General page of the DHS website.
• Report suspected fraud by phone at 877-865-3432 or online at reportfraud.wisconsin.gov.

Additional Resources

• Members can contact Member Services at 800-362-3002 for questions about enrollment, general program information, finding providers, and other concerns.
• Find resources for HMOs and managed care organizations (MCOs) on the Portal:
  • The Resources and Help tab of the HMO Providers page has a list of HMO contacts.
  • The Help and Contacts tab of the Family Care, Family Care Partnership, PACE Providers page has key contact information for each Family Care, Family Care Partnership, and Program of All-Inclusive Care for the Elderly (PACE) MCO.
• Visit the DHS Division of Quality Assurance Provider Portal for information regarding certification.
• Contact the Division of Care and Treatment Services by email at DHSDCTS72@dhs.wisconsin.gov for questions about Wis. Admin. Code ch. DHS 72 implementation.