children’s psychiatric drugs in kentucky medicaid: kentucky’s own three numbers
kentucky told cms three things about its children in the 2025 reporting year: 62.7 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 19th of the 50 states that reported it; 31.8 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 17th of the 49 states that reported it; 53.7 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 13th of the 51 states that reported it.[1]
across the whole age range, kentucky sits in the top quarter of the country on the 30-day adhd follow-up and below the national median on the two metabolic blood tests. same state, same year, same children.
every row kentucky sent to cms
| measure | kentucky | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 62.7 | withheld | 19 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 65.6 | withheld | 21 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 64.0 | 7,127 | 20 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 31.8 | withheld | 17 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 31.8 | withheld | 36 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 31.8 | 177,858 | 31 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 51.1 | 177,858 | 36 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 33.0 | 177,858 | 30 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 53.7 | 8,992 | 13 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 63.4 | 3,521 | 5 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, kentucky reported 62.7 percent — 3.5 points above the national median of 59.2, and 19th of the 50 states that reported it. put the other way round, 37.3 percent of the youngest children in kentucky who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 65.6 percent. across ages 1 to 17, 64.0 percent on 7,127 children, 20th of the 51 states that reported it. it reported 64.5 the year before on the same method, so this one moved 0.5 points down — the only one of the three where that comparison holds. either side of kentucky on that row: wisconsin at 65.0 and nevada at 63.8.
the two blood tests
kentucky reported that 31.8 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 17th of the 49 states that reported it, 2.7 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 51.1 percent and cholesterol 33.0 percent, both on 177,858 children — 36th of the 51 states that reported it on glucose, 30th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 31.8 percent. either side of kentucky on the both-tests row for ages 1 to 17: nevada at 32.1 and oregon at 31.4.
the 30-day visit after a new adhd prescription
53.7 percent, on 8,992 children aged 6 to 12 who were newly prescribed an adhd medicine in kentucky — 13th of the 51 states that reported it, 6.1 points above the national median of 47.6. that leaves 46.3 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 63.4 percent had at least two more visits on 3,521 children, against a national median of 55.5 — the fifth-highest of the 49 states that reported it. either side of kentucky on the 30-day row: nevada at 54.2 and ohio at 53.6.
what medicaid paid for in kentucky in 2024
in 2024 medicaid in kentucky paid for 336,752 hydroxyzine prescriptions, $3,927,347 worth, and 308,652 benzodiazepine prescriptions, $4,570,205 worth — 109.1 hydroxyzine prescriptions for every 100 benzodiazepine ones. 124 of the 613 hydroxyzine rows and 998 of the 2,350 benzodiazepine rows for kentucky 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 kentucky’s own numbers behind them
ask which drug it is, not which class
kentucky, 2024: 336,752 hydroxyzine prescriptions and 308,652 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
kentucky: 62.7 percent of children aged 1 to 11, 19th of the 50 states that reported it
in 37.3 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
kentucky: 31.8 percent of children aged 1 to 11 had both tests, 17th of the 49 states that reported it
missed 68.2 percent of the time in kentucky. 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
kentucky: 53.7 percent, 13th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and kentucky misses it 46.3 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 Kentucky, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Kentucky reported 62.7 percent for children aged 1 to 11, against a national median of 59.2 percent — 19th of the 50 states that reported it. For ages 12 to 17 it was 65.6 percent, and across ages 1 to 17 64.0 percent on 7,127 children.
In Kentucky, do children on antipsychotics get the blood tests?
31.8 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 17th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 51.1 percent, cholesterol 33.0 percent, on 177,858 children.
In Kentucky, how often does the 30-day ADHD follow-up visit happen?
53.7 percent of the time, on 8,992 children aged 6 to 12 newly prescribed an ADHD medicine — 13th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 63.4 percent in Kentucky against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Kentucky rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 62.7 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 65.6 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 64.0 on a denominator of 7,127; APM-CH both blood tests, 1 to 11: 31.8 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 31.8 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 31.8 on a denominator of 177,858; APM-CH glucose alone, 1 to 17: 51.1 on a denominator of 177,858; APM-CH cholesterol alone, 1 to 17: 33.0 on a denominator of 177,858; ADD-CH 30-day adhd follow-up, 6 to 12: 53.7 on a denominator of 8,992; ADD-CH nine-month adhd follow-up, 6 to 12: 63.4 on a denominator of 3,521. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Kentucky rows, summed by product name, read 2026-09-28: hydroxyzine 336,752 prescriptions, $3,927,347, 124 of 613 rows suppressed; benzodiazepines 308,652 prescriptions, $4,570,205, 998 of 2,350 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