children’s psychiatric drugs in maryland medicaid: maryland’s own three numbers
maryland told cms three things about its children in the 2025 reporting year: 73.8 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 7th of the 50 states that reported it; 60.5 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, the second-highest of the 49 states that reported it; 64.2 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, the highest of the 51 states that reported it.[1]
across the whole age range, maryland sits in the top quarter of the country on the 30-day adhd follow-up and in the top quarter of the country on psychosocial care before an antipsychotic. same state, same year, same children.
every row maryland sent to cms
| measure | maryland | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 73.8 | withheld | 7 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 71.0 | withheld | 10 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 71.8 | 1,505 | 7 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 60.5 | withheld | 2 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 57.2 | withheld | 3 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 58.1 | 4,353 | 2 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 69.3 | 4,353 | 6 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 59.5 | 4,353 | 2 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 64.2 | 6,301 | 1 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 25.0 | 6,301 | 49 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, maryland reported 73.8 percent — 14.6 points above the national median of 59.2, and 7th of the 50 states that reported it. put the other way round, 26.2 percent of the youngest children in maryland who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 71.0 percent. across ages 1 to 17, 71.8 percent on 1,505 children, 7th of the 51 states that reported it. it reported 67.9 the year before on the same method, so this one moved 3.9 points up — the only one of the three where that comparison holds. either side of maryland on that row: ohio at 75.6 and massachusetts at 71.7.
the two blood tests
maryland reported that 60.5 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the second-highest of the 49 states that reported it, 31.4 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 69.3 percent and cholesterol 59.5 percent, both on 4,353 children — 6th of the 51 states that reported it on glucose, the second-highest of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 58.1 percent. either side of maryland on the both-tests row for ages 1 to 17: west virginia at 59.7 and arkansas at 56.8.
the 30-day visit after a new adhd prescription
64.2 percent, on 6,301 children aged 6 to 12 who were newly prescribed an adhd medicine in maryland — the highest of the 51 states that reported it, 16.6 points above the national median of 47.6. that leaves 35.8 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 25.0 percent had at least two more visits on 6,301 children, against a national median of 55.5 — the lowest of the 49 states that reported it. either side of maryland on the 30-day row: west virginia at 62.8.
what medicaid paid for in maryland in 2024
in 2024 medicaid in maryland paid for 197,741 hydroxyzine prescriptions, $2,914,548 worth, and 298,808 benzodiazepine prescriptions, $4,833,927 worth — 66.2 hydroxyzine prescriptions for every 100 benzodiazepine ones. 57 of the 323 hydroxyzine rows and 559 of the 1,436 benzodiazepine rows for maryland 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 maryland’s own numbers behind them
ask which drug it is, not which class
maryland, 2024: 197,741 hydroxyzine prescriptions and 298,808 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
maryland: 73.8 percent of children aged 1 to 11, 7th of the 50 states that reported it
in 26.2 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
maryland: 60.5 percent of children aged 1 to 11 had both tests, the second-highest of the 49 states that reported it
missed 39.5 percent of the time in maryland. 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
maryland: 64.2 percent, the highest of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and maryland misses it 35.8 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 Maryland, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Maryland reported 73.8 percent for children aged 1 to 11, against a national median of 59.2 percent — 7th of the 50 states that reported it. For ages 12 to 17 it was 71.0 percent, and across ages 1 to 17 71.8 percent on 1,505 children.
In Maryland, do children on antipsychotics get the blood tests?
60.5 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the second-highest of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 69.3 percent, cholesterol 59.5 percent, on 4,353 children.
In Maryland, how often does the 30-day ADHD follow-up visit happen?
64.2 percent of the time, on 6,301 children aged 6 to 12 newly prescribed an ADHD medicine — the highest of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 25.0 percent in Maryland against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Maryland rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 73.8 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 71.0 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 71.8 on a denominator of 1,505; APM-CH both blood tests, 1 to 11: 60.5 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 57.2 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 58.1 on a denominator of 4,353; APM-CH glucose alone, 1 to 17: 69.3 on a denominator of 4,353; APM-CH cholesterol alone, 1 to 17: 59.5 on a denominator of 4,353; ADD-CH 30-day adhd follow-up, 6 to 12: 64.2 on a denominator of 6,301; ADD-CH nine-month adhd follow-up, 6 to 12: 25.0 on a denominator of 6,301. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Maryland rows, summed by product name, read 2026-09-28: hydroxyzine 197,741 prescriptions, $2,914,548, 57 of 323 rows suppressed; benzodiazepines 298,808 prescriptions, $4,833,927, 559 of 1,436 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