children’s psychiatric drugs in illinois medicaid: illinois’s own three numbers
illinois told cms three things about its children in the 2025 reporting year: 55.3 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 35th of the 50 states that reported it; 26.3 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 29th of the 49 states that reported it; 35.2 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, the fifth-lowest of the 51 states that reported it.[1]
across the whole age range, illinois sits below the national median on the two metabolic blood tests and in the bottom quarter of the country on the 30-day adhd follow-up. same state, same year, same children.
every row illinois sent to cms
| measure | illinois | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 55.3 | withheld | 35 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 63.9 | withheld | 26 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 60.7 | 5,404 | 29 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 26.3 | withheld | 29 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 35.3 | withheld | 29 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 32.4 | withheld | 27 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 59.3 | withheld | 12 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 33.2 | withheld | 29 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 35.2 | 14,058 | 47 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 41.2 | 3,476 | 45 of 49 | 55.5 |
rank 1 is the highest rate. how the ranks and the withheld cells work.[1]
talking treatment before the antipsychotic
for the youngest children, aged 1 to 11, illinois reported 55.3 percent — 3.9 points below the national median of 59.2, and 35th of the 50 states that reported it. put the other way round, 44.7 percent of the youngest children in illinois who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 63.9 percent. across ages 1 to 17, 60.7 percent on 5,404 children, 29th of the 51 states that reported it. it reported 59.7 the year before on the same method, so this one moved 1.0 points up — the only one of the three where that comparison holds. either side of illinois on that row: alabama at 60.9 and tennessee at 60.6.
the two blood tests
illinois reported that 26.3 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 29th of the 49 states that reported it, 2.8 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 59.3 percent and cholesterol 33.2 percent — 12th of the 51 states that reported it on glucose, 29th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 32.4 percent. either side of illinois on the both-tests row for ages 1 to 17: georgia at 32.4 and ohio at 32.4.
the 30-day visit after a new adhd prescription
35.2 percent, on 14,058 children aged 6 to 12 who were newly prescribed an adhd medicine in illinois — the fifth-lowest of the 51 states that reported it, 12.4 points below the national median of 47.6. that leaves 64.8 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 41.2 percent had at least two more visits on 3,476 children, against a national median of 55.5 — the fifth-lowest of the 49 states that reported it. either side of illinois on the 30-day row: delaware at 35.3 and district of columbia at 34.4.
what medicaid paid for in illinois in 2024
in 2024 medicaid in illinois paid for 260,097 hydroxyzine prescriptions, $2,442,982 worth, and 481,685 benzodiazepine prescriptions, $6,115,270 worth — 54.0 hydroxyzine prescriptions for every 100 benzodiazepine ones. 116 of the 520 hydroxyzine rows and 783 of the 2,041 benzodiazepine rows for illinois were suppressed, so both are floors.[2] our own sums of the federal file, which has no ages, so neither is a children’s number, and no rank.
four things to ask, with illinois’s own numbers behind them
ask which drug it is, not which class
illinois, 2024: 260,097 hydroxyzine prescriptions and 481,685 benzodiazepine prescriptions
hydroxyzine is an antihistamine; a benzodiazepine brings dependence and withdrawal. read the name on the bottle. why they get merged.
if an antipsychotic is being started, ask what came first
illinois: 55.3 percent of children aged 1 to 11, 35th of the 50 states that reported it
in 44.7 percent of these cases the answer is “none yet”. ask what was tried first, and ask for it in the notes.
if your child is on an antipsychotic, get the date of the bloodwork
illinois: 26.3 percent of children aged 1 to 11 had both tests, 29th of the 49 states that reported it
missed 73.7 percent of the time in illinois. ask when the glucose and cholesterol test is booked, and leave with a date.
if an adhd medicine has just been started, book the 30-day visit now
illinois: 35.2 percent, the fifth-lowest of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and illinois misses it 64.8 percent of the time. book it before you leave the room.
how to read any of this
self-reported, on methods that differ by state, and process not outcome.[1] method and suppression rules; the national picture.
questions people ask
In Illinois, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Illinois reported 55.3 percent for children aged 1 to 11, against a national median of 59.2 percent — 35th of the 50 states that reported it. For ages 12 to 17 it was 63.9 percent, and across ages 1 to 17 60.7 percent on 5,404 children.
In Illinois, do children on antipsychotics get the blood tests?
26.3 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 29th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 59.3 percent, cholesterol 33.2 percent.
In Illinois, how often does the 30-day ADHD follow-up visit happen?
35.2 percent of the time, on 14,058 children aged 6 to 12 newly prescribed an ADHD medicine — the fifth-lowest of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 41.2 percent in Illinois against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Illinois rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 55.3 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 63.9 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 60.7 on a denominator of 5,404; APM-CH both blood tests, 1 to 11: 26.3 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 35.3 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 32.4 (denominator not publicly reported); APM-CH glucose alone, 1 to 17: 59.3 (denominator not publicly reported); APM-CH cholesterol alone, 1 to 17: 33.2 (denominator not publicly reported); ADD-CH 30-day adhd follow-up, 6 to 12: 35.2 on a denominator of 14,058; ADD-CH nine-month adhd follow-up, 6 to 12: 41.2 on a denominator of 3,476. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Illinois rows, summed by product name, read 2026-09-28: hydroxyzine 260,097 prescriptions, $2,442,982, 116 of 520 rows suppressed; benzodiazepines 481,685 prescriptions, $6,115,270, 783 of 2,041 rows suppressed. Our sum, not a CMS statistic. https://data.medicaid.gov/dataset/61729e5a-7aa8-448c-8903-ba3e0cd0ea3c
all 51 states ranked · what the national numbers say
nothing here is a reason to start, stop or change a child’s medication. it is a set of questions to bring to the person who prescribes it.
adam