children’s psychiatric drugs in south dakota medicaid: south dakota’s own three numbers
south dakota told cms three things about its children in the 2025 reporting year: 56.7 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 32nd of the 50 states that reported it; 23.7 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 36th of the 49 states that reported it; 50.0 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 18th of the 51 states that reported it.[1]
across the whole age range, south dakota sits above the national median on the 30-day adhd follow-up and in the bottom quarter of the country on psychosocial care before an antipsychotic. same state, same year, same children.
every row south dakota sent to cms
| measure | south dakota | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 56.7 | withheld | 32 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 51.8 | withheld | 45 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 53.6 | withheld | 44 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 23.7 | withheld | 36 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 33.7 | withheld | 31 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 30.2 | 1,074 | 35 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 50.2 | 1,074 | 39 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 31.3 | 1,074 | 36 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 50.0 | 1,048 | 18 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 55.0 | withheld | 26 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, south dakota reported 56.7 percent — 2.5 points below the national median of 59.2, and 32nd of the 50 states that reported it. put the other way round, 43.3 percent of the youngest children in south dakota who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 51.8 percent. across ages 1 to 17, 53.6 percent, 44th of the 51 states that reported it. it reported 48.3 the year before on the same method, so this one moved 5.3 points up — the only one of the three where that comparison holds. either side of south dakota on that row: missouri at 53.6 and delaware at 53.3.
the two blood tests
south dakota reported that 23.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 36th of the 49 states that reported it, 5.4 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 50.2 percent and cholesterol 31.3 percent, both on 1,074 children — 39th of the 51 states that reported it on glucose, 36th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 30.2 percent. either side of south dakota on the both-tests row for ages 1 to 17: wisconsin at 30.3 and colorado at 30.1.
the 30-day visit after a new adhd prescription
50.0 percent, on 1,048 children aged 6 to 12 who were newly prescribed an adhd medicine in south dakota — 18th of the 51 states that reported it, 2.4 points above the national median of 47.6. that leaves 50.0 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 55.0 percent had at least two more visits, against a national median of 55.5 — 26th of the 49 states that reported it. either side of south dakota on the 30-day row: north carolina at 51.1 and california at 49.6.
what medicaid paid for in south dakota in 2024
in 2024 medicaid in south dakota paid for 16,137 hydroxyzine prescriptions, $1,304,928 worth, and 23,656 benzodiazepine prescriptions, $1,148,097 worth — 68.2 hydroxyzine prescriptions for every 100 benzodiazepine ones. 73 of the 251 hydroxyzine rows and 539 of the 979 benzodiazepine rows for south dakota 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 south dakota’s own numbers behind them
ask which drug it is, not which class
south dakota, 2024: 16,137 hydroxyzine prescriptions and 23,656 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
south dakota: 56.7 percent of children aged 1 to 11, 32nd of the 50 states that reported it
in 43.3 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
south dakota: 23.7 percent of children aged 1 to 11 had both tests, 36th of the 49 states that reported it
missed 76.3 percent of the time in south dakota. 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
south dakota: 50.0 percent, 18th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and south dakota misses it 50.0 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 South Dakota, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year South Dakota reported 56.7 percent for children aged 1 to 11, against a national median of 59.2 percent — 32nd of the 50 states that reported it. For ages 12 to 17 it was 51.8 percent, and across ages 1 to 17 53.6 percent.
In South Dakota, do children on antipsychotics get the blood tests?
23.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 36th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 50.2 percent, cholesterol 31.3 percent, on 1,074 children.
In South Dakota, how often does the 30-day ADHD follow-up visit happen?
50.0 percent of the time, on 1,048 children aged 6 to 12 newly prescribed an ADHD medicine — 18th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 55.0 percent in South Dakota against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, South Dakota rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 56.7 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 51.8 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 53.6 (denominator not publicly reported); APM-CH both blood tests, 1 to 11: 23.7 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 33.7 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 30.2 on a denominator of 1,074; APM-CH glucose alone, 1 to 17: 50.2 on a denominator of 1,074; APM-CH cholesterol alone, 1 to 17: 31.3 on a denominator of 1,074; ADD-CH 30-day adhd follow-up, 6 to 12: 50.0 on a denominator of 1,048; ADD-CH nine-month adhd follow-up, 6 to 12: 55.0 (denominator not publicly reported). Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, South Dakota rows, summed by product name, read 2026-09-28: hydroxyzine 16,137 prescriptions, $1,304,928, 73 of 251 rows suppressed; benzodiazepines 23,656 prescriptions, $1,148,097, 539 of 979 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