children’s psychiatric drugs in minnesota medicaid: minnesota’s own three numbers
minnesota told cms three things about its children in the 2025 reporting year: 74.4 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, the fifth-highest of the 50 states that reported it; 0.6 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, the lowest of the 51 states that reported it; 39.1 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 43rd of the 51 states that reported it.[1]
across the whole age range, minnesota sits in the top quarter of the country on psychosocial care before an antipsychotic and in the bottom quarter of the country on the two metabolic blood tests. same state, same year, same children.
every row minnesota sent to cms
| measure | minnesota | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 74.4 | withheld | 5 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 81.6 | withheld | 1 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 79.3 | 1,399 | 1 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | suppressed | withheld | — | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 0.8 | withheld | 51 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 0.6 | 5,812 | 51 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 54.4 | 5,812 | 25 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 0.8 | 5,812 | 51 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 39.1 | 7,346 | 43 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 45.2 | 2,970 | 41 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, minnesota reported 74.4 percent — 15.2 points above the national median of 59.2, and the fifth-highest of the 50 states that reported it. put the other way round, 25.6 percent of the youngest children in minnesota who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 81.6 percent. across ages 1 to 17, 79.3 percent on 1,399 children, the highest of the 51 states that reported it. it reported 77.9 the year before on the same method, so this one moved 1.4 points up — the only one of the three where that comparison holds. either side of minnesota on that row: arkansas at 78.8.
the two blood tests
minnesota reported that 0.6 percent of children aged 1 to 17 on two or more antipsychotic prescriptions had both tests — the lowest of the 51 states that reported it, 32.3 points below the national median of 32.9. split into halves across ages 1 to 17, glucose ran 54.4 percent and cholesterol 0.8 percent, both on 5,812 children — 25th of the 51 states that reported it on glucose, the lowest of the 51 states that reported it on cholesterol. either side of minnesota on the both-tests row for ages 1 to 17: district of columbia at 10.9.
the 30-day visit after a new adhd prescription
39.1 percent, on 7,346 children aged 6 to 12 who were newly prescribed an adhd medicine in minnesota — 43rd of the 51 states that reported it, 8.5 points below the national median of 47.6. that leaves 60.9 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 45.2 percent had at least two more visits on 2,970 children, against a national median of 55.5 — 41st of the 49 states that reported it. either side of minnesota on the 30-day row: new mexico at 39.9 and alaska at 39.0.
what is missing from minnesota’s file, and why
- APM-CH both blood tests, 1 to 11: Minnesota reported this measure for 2025, and CMS suppressed the cell: this cell is not published because the number of children behind it is small enough that publishing it could identify them. That is a withheld number, not a zero.
a break in minnesota’s own series, not a collapse in care
minnesota reported 36.8 on both blood tests, 12 to 17 in the 2024 reporting year and 0.8 in 2025, a move of 36.0 points. minnesota reported 35.3 on both blood tests, 1 to 17 in the 2024 reporting year and 0.6 in 2025, a move of 34.7 points. minnesota reported 36.4 on cholesterol alone, 1 to 17 in the 2024 reporting year and 0.8 in 2025, a move of 35.6 points. between those two years every reporting state in the country switched these measures from claims data to electronic clinical data systems, so the instrument changed underneath the numbers. moves that size are a change in how the counting was done before they are anything about clinics in minnesota, and we are not going to read them as one. every state where this happened.
what medicaid paid for in minnesota in 2024
in 2024 medicaid in minnesota paid for 181,096 hydroxyzine prescriptions, $2,535,438 worth, and 201,440 benzodiazepine prescriptions, $2,394,821 worth — 89.9 hydroxyzine prescriptions for every 100 benzodiazepine ones. 157 of the 604 hydroxyzine rows and 941 of the 2,093 benzodiazepine rows for minnesota 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 minnesota’s own numbers behind them
ask which drug it is, not which class
minnesota, 2024: 181,096 hydroxyzine prescriptions and 201,440 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
minnesota: 74.4 percent of children aged 1 to 11, the fifth-highest of the 50 states that reported it
in 25.6 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
minnesota: 0.6 percent of children aged 1 to 17 had both tests, the lowest of the 51 states that reported it
missed 99.4 percent of the time in minnesota. 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
minnesota: 39.1 percent, 43rd of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and minnesota misses it 60.9 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 Minnesota, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Minnesota reported 74.4 percent for children aged 1 to 11, against a national median of 59.2 percent — the fifth-highest of the 50 states that reported it. For ages 12 to 17 it was 81.6 percent, and across ages 1 to 17 79.3 percent on 1,399 children.
In Minnesota, do children on antipsychotics get the blood tests?
0.6 percent of children aged 1 to 17 on two or more antipsychotic prescriptions had both tests — the lowest of the 51 states that reported it, against a national median of 32.9 percent. Across ages 1 to 17: glucose 54.4 percent, cholesterol 0.8 percent, on 5,812 children.
In Minnesota, how often does the 30-day ADHD follow-up visit happen?
39.1 percent of the time, on 7,346 children aged 6 to 12 newly prescribed an ADHD medicine — 43rd of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 45.2 percent in Minnesota against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Minnesota rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 74.4 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 81.6 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 79.3 on a denominator of 1,399; APM-CH both blood tests, 1 to 11: DS, data suppressed; APM-CH both blood tests, 12 to 17: 0.8 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 0.6 on a denominator of 5,812; APM-CH glucose alone, 1 to 17: 54.4 on a denominator of 5,812; APM-CH cholesterol alone, 1 to 17: 0.8 on a denominator of 5,812; ADD-CH 30-day adhd follow-up, 6 to 12: 39.1 on a denominator of 7,346; ADD-CH nine-month adhd follow-up, 6 to 12: 45.2 on a denominator of 2,970. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Minnesota rows, summed by product name, read 2026-09-28: hydroxyzine 181,096 prescriptions, $2,535,438, 157 of 604 rows suppressed; benzodiazepines 201,440 prescriptions, $2,394,821, 941 of 2,093 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 · minnesota, city by city
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