children’s psychiatric drugs in nebraska medicaid: nebraska’s own three numbers
nebraska told cms three things about its children in the 2025 reporting year: 52.0 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 43rd of the 50 states that reported it; 29.8 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 20th of the 49 states that reported it; 46.6 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 28th of the 51 states that reported it.[1]
across the whole age range, nebraska sits above the national median on the two metabolic blood tests and in the bottom quarter of the country on psychosocial care before an antipsychotic. same state, same year, same children.
every row nebraska sent to cms
| measure | nebraska | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 52.0 | withheld | 43 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 61.8 | withheld | 34 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 58.3 | 993 | 40 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 29.8 | withheld | 20 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 36.1 | withheld | 28 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 33.7 | 2,757 | 24 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 53.5 | 2,757 | 32 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 35.2 | 2,757 | 24 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 46.6 | 2,043 | 28 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 50.1 | 740 | 34 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, nebraska reported 52.0 percent — 7.2 points below the national median of 59.2, and 43rd of the 50 states that reported it. put the other way round, 48.0 percent of the youngest children in nebraska who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 61.8 percent. across ages 1 to 17, 58.3 percent on 993 children, 40th of the 51 states that reported it. it reported 59.7 the year before on the same method, so this one moved 1.4 points down — the only one of the three where that comparison holds. either side of nebraska on that row: virginia at 58.8 and utah at 56.6.
the two blood tests
nebraska reported that 29.8 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 20th of the 49 states that reported it, 0.7 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 53.5 percent and cholesterol 35.2 percent, both on 2,757 children — 32nd of the 51 states that reported it on glucose, 24th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 33.7 percent. either side of nebraska on the both-tests row for ages 1 to 17: north carolina at 34.9 and new jersey at 32.9.
the 30-day visit after a new adhd prescription
46.6 percent, on 2,043 children aged 6 to 12 who were newly prescribed an adhd medicine in nebraska — 28th of the 51 states that reported it, 1.0 points below the national median of 47.6. that leaves 53.4 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 50.1 percent had at least two more visits on 740 children, against a national median of 55.5 — 34th of the 49 states that reported it. either side of nebraska on the 30-day row: florida at 46.7 and louisiana at 45.9.
what medicaid paid for in nebraska in 2024
in 2024 medicaid in nebraska paid for 38,911 hydroxyzine prescriptions, $361,537 worth, and 87,280 benzodiazepine prescriptions, $1,493,950 worth — 44.6 hydroxyzine prescriptions for every 100 benzodiazepine ones. 57 of the 254 hydroxyzine rows and 486 of the 1,196 benzodiazepine rows for nebraska 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 nebraska’s own numbers behind them
ask which drug it is, not which class
nebraska, 2024: 38,911 hydroxyzine prescriptions and 87,280 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
nebraska: 52.0 percent of children aged 1 to 11, 43rd of the 50 states that reported it
in 48.0 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
nebraska: 29.8 percent of children aged 1 to 11 had both tests, 20th of the 49 states that reported it
missed 70.2 percent of the time in nebraska. 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
nebraska: 46.6 percent, 28th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and nebraska misses it 53.4 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 Nebraska, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Nebraska reported 52.0 percent for children aged 1 to 11, against a national median of 59.2 percent — 43rd of the 50 states that reported it. For ages 12 to 17 it was 61.8 percent, and across ages 1 to 17 58.3 percent on 993 children.
In Nebraska, do children on antipsychotics get the blood tests?
29.8 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 20th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 53.5 percent, cholesterol 35.2 percent, on 2,757 children.
In Nebraska, how often does the 30-day ADHD follow-up visit happen?
46.6 percent of the time, on 2,043 children aged 6 to 12 newly prescribed an ADHD medicine — 28th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 50.1 percent in Nebraska against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Nebraska rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 52.0 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 61.8 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 58.3 on a denominator of 993; APM-CH both blood tests, 1 to 11: 29.8 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 36.1 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 33.7 on a denominator of 2,757; APM-CH glucose alone, 1 to 17: 53.5 on a denominator of 2,757; APM-CH cholesterol alone, 1 to 17: 35.2 on a denominator of 2,757; ADD-CH 30-day adhd follow-up, 6 to 12: 46.6 on a denominator of 2,043; ADD-CH nine-month adhd follow-up, 6 to 12: 50.1 on a denominator of 740. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Nebraska rows, summed by product name, read 2026-09-28: hydroxyzine 38,911 prescriptions, $361,537, 57 of 254 rows suppressed; benzodiazepines 87,280 prescriptions, $1,493,950, 486 of 1,196 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