children’s psychiatric drugs in pennsylvania medicaid: pennsylvania’s own three numbers
pennsylvania told cms three things about its children in the 2025 reporting year: 58.5 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 28th of the 50 states that reported it; 59.2 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, the fourth-highest of the 49 states that reported it; 48.3 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 22nd of the 51 states that reported it.[1]
across the whole age range, pennsylvania sits in the top quarter of the country on the two metabolic blood tests and below the national median on psychosocial care before an antipsychotic. same state, same year, same children.
every row pennsylvania sent to cms
| measure | pennsylvania | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 58.5 | withheld | 28 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 60.3 | withheld | 38 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 59.8 | 3,353 | 33 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 59.2 | withheld | 4 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 55.0 | withheld | 5 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 56.3 | 13,641 | 4 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 70.3 | 13,641 | 4 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 58.7 | 13,641 | 3 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 48.3 | 10,024 | 22 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 53.9 | 7,116 | 28 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, pennsylvania reported 58.5 percent — 0.7 points below the national median of 59.2, and 28th of the 50 states that reported it. put the other way round, 41.5 percent of the youngest children in pennsylvania who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 60.3 percent. across ages 1 to 17, 59.8 percent on 3,353 children, 33rd of the 51 states that reported it. it reported 57.1 the year before on the same method, so this one moved 2.7 points up — the only one of the three where that comparison holds. either side of pennsylvania on that row: alaska at 59.8 and indiana at 59.1.
the two blood tests
pennsylvania reported that 59.2 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fourth-highest of the 49 states that reported it, 30.1 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 70.3 percent and cholesterol 58.7 percent, both on 13,641 children — the fourth-highest of the 51 states that reported it on glucose, the third-highest of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 56.3 percent. either side of pennsylvania on the both-tests row for ages 1 to 17: arkansas at 56.8 and montana at 51.9.
the 30-day visit after a new adhd prescription
48.3 percent, on 10,024 children aged 6 to 12 who were newly prescribed an adhd medicine in pennsylvania — 22nd of the 51 states that reported it, 0.7 points above the national median of 47.6. that leaves 51.7 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 53.9 percent had at least two more visits on 7,116 children, against a national median of 55.5 — 28th of the 49 states that reported it. either side of pennsylvania on the 30-day row: tennessee at 48.9 and wisconsin at 48.3.
what medicaid paid for in pennsylvania in 2024
in 2024 medicaid in pennsylvania paid for 445,028 hydroxyzine prescriptions, $4,290,912 worth, and 646,150 benzodiazepine prescriptions, $11,796,973 worth — 68.9 hydroxyzine prescriptions for every 100 benzodiazepine ones. 144 of the 531 hydroxyzine rows and 841 of the 2,041 benzodiazepine rows for pennsylvania 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 pennsylvania’s own numbers behind them
ask which drug it is, not which class
pennsylvania, 2024: 445,028 hydroxyzine prescriptions and 646,150 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
pennsylvania: 58.5 percent of children aged 1 to 11, 28th of the 50 states that reported it
in 41.5 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
pennsylvania: 59.2 percent of children aged 1 to 11 had both tests, the fourth-highest of the 49 states that reported it
missed 40.8 percent of the time in pennsylvania. 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
pennsylvania: 48.3 percent, 22nd of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and pennsylvania misses it 51.7 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 Pennsylvania, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Pennsylvania reported 58.5 percent for children aged 1 to 11, against a national median of 59.2 percent — 28th of the 50 states that reported it. For ages 12 to 17 it was 60.3 percent, and across ages 1 to 17 59.8 percent on 3,353 children.
In Pennsylvania, do children on antipsychotics get the blood tests?
59.2 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fourth-highest of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 70.3 percent, cholesterol 58.7 percent, on 13,641 children.
In Pennsylvania, how often does the 30-day ADHD follow-up visit happen?
48.3 percent of the time, on 10,024 children aged 6 to 12 newly prescribed an ADHD medicine — 22nd of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 53.9 percent in Pennsylvania against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Pennsylvania rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 58.5 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 60.3 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 59.8 on a denominator of 3,353; APM-CH both blood tests, 1 to 11: 59.2 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 55.0 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 56.3 on a denominator of 13,641; APM-CH glucose alone, 1 to 17: 70.3 on a denominator of 13,641; APM-CH cholesterol alone, 1 to 17: 58.7 on a denominator of 13,641; ADD-CH 30-day adhd follow-up, 6 to 12: 48.3 on a denominator of 10,024; ADD-CH nine-month adhd follow-up, 6 to 12: 53.9 on a denominator of 7,116. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Pennsylvania rows, summed by product name, read 2026-09-28: hydroxyzine 445,028 prescriptions, $4,290,912, 144 of 531 rows suppressed; benzodiazepines 646,150 prescriptions, $11,796,973, 841 of 2,041 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