children’s psychiatric drugs in michigan medicaid: michigan’s own three numbers
michigan told cms three things about its children in the 2025 reporting year: 66.1 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 14th of the 50 states that reported it; 22.5 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 40th of the 49 states that reported it; 51.8 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 16th of the 51 states that reported it.[1]
across the whole age range, michigan sits above the national median on the 30-day adhd follow-up and in the bottom quarter of the country on the two metabolic blood tests. same state, same year, same children.
every row michigan sent to cms
| measure | michigan | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 66.1 | withheld | 14 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 68.0 | withheld | 17 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 67.4 | 3,947 | 17 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 22.5 | withheld | 40 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 30.9 | withheld | 38 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 28.1 | 10,991 | 39 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 50.1 | 10,991 | 40 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 29.4 | 10,991 | 40 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 51.8 | 10,920 | 16 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 60.9 | 3,682 | 13 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, michigan reported 66.1 percent — 6.9 points above the national median of 59.2, and 14th of the 50 states that reported it. put the other way round, 33.9 percent of the youngest children in michigan who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 68.0 percent. across ages 1 to 17, 67.4 percent on 3,947 children, 17th of the 51 states that reported it. it reported 65.6 the year before on the same method, so this one moved 1.8 points up — the only one of the three where that comparison holds. either side of michigan on that row: oregon at 67.6 and louisiana at 65.9.
the two blood tests
michigan reported that 22.5 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 40th of the 49 states that reported it, 6.6 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 50.1 percent and cholesterol 29.4 percent, both on 10,991 children — 40th of the 51 states that reported it on glucose, 40th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 28.1 percent. either side of michigan on the both-tests row for ages 1 to 17: louisiana at 28.5 and utah at 28.1.
the 30-day visit after a new adhd prescription
51.8 percent, on 10,920 children aged 6 to 12 who were newly prescribed an adhd medicine in michigan — 16th of the 51 states that reported it, 4.2 points above the national median of 47.6. that leaves 48.2 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 60.9 percent had at least two more visits on 3,682 children, against a national median of 55.5 — 13th of the 49 states that reported it. either side of michigan on the 30-day row: kansas at 53.0 and north carolina at 51.1.
what medicaid paid for in michigan in 2024
in 2024 medicaid in michigan paid for 312,200 hydroxyzine prescriptions, $2,169,440 worth, and 462,500 benzodiazepine prescriptions, $12,397,451 worth — 67.5 hydroxyzine prescriptions for every 100 benzodiazepine ones. 155 of the 627 hydroxyzine rows and 514 of the 1,370 benzodiazepine rows for michigan 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 michigan’s own numbers behind them
ask which drug it is, not which class
michigan, 2024: 312,200 hydroxyzine prescriptions and 462,500 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
michigan: 66.1 percent of children aged 1 to 11, 14th of the 50 states that reported it
in 33.9 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
michigan: 22.5 percent of children aged 1 to 11 had both tests, 40th of the 49 states that reported it
missed 77.5 percent of the time in michigan. 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
michigan: 51.8 percent, 16th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and michigan misses it 48.2 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 Michigan, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Michigan reported 66.1 percent for children aged 1 to 11, against a national median of 59.2 percent — 14th of the 50 states that reported it. For ages 12 to 17 it was 68.0 percent, and across ages 1 to 17 67.4 percent on 3,947 children.
In Michigan, do children on antipsychotics get the blood tests?
22.5 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 40th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 50.1 percent, cholesterol 29.4 percent, on 10,991 children.
In Michigan, how often does the 30-day ADHD follow-up visit happen?
51.8 percent of the time, on 10,920 children aged 6 to 12 newly prescribed an ADHD medicine — 16th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 60.9 percent in Michigan against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Michigan rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 66.1 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 68.0 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 67.4 on a denominator of 3,947; APM-CH both blood tests, 1 to 11: 22.5 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 30.9 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 28.1 on a denominator of 10,991; APM-CH glucose alone, 1 to 17: 50.1 on a denominator of 10,991; APM-CH cholesterol alone, 1 to 17: 29.4 on a denominator of 10,991; ADD-CH 30-day adhd follow-up, 6 to 12: 51.8 on a denominator of 10,920; ADD-CH nine-month adhd follow-up, 6 to 12: 60.9 on a denominator of 3,682. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Michigan rows, summed by product name, read 2026-09-28: hydroxyzine 312,200 prescriptions, $2,169,440, 155 of 627 rows suppressed; benzodiazepines 462,500 prescriptions, $12,397,451, 514 of 1,370 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