children’s psychiatric drugs in tennessee medicaid: tennessee’s own three numbers
tennessee told cms three things about its children in the 2025 reporting year: 55.7 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 34th of the 50 states that reported it; 29.6 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 23rd of the 49 states that reported it; 48.9 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 21st of the 51 states that reported it.[1]
across the whole age range, tennessee 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 tennessee sent to cms
| measure | tennessee | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 55.7 | withheld | 34 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 63.0 | withheld | 29 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 60.6 | 3,379 | 30 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 29.6 | withheld | 23 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 45.9 | withheld | 9 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 40.3 | 9,688 | 12 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 57.0 | 9,688 | 16 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 43.3 | 9,688 | 9 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 48.9 | 12,340 | 21 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 56.2 | 4,283 | 22 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, tennessee reported 55.7 percent — 3.5 points below the national median of 59.2, and 34th of the 50 states that reported it. put the other way round, 44.3 percent of the youngest children in tennessee who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 63.0 percent. across ages 1 to 17, 60.6 percent on 3,379 children, 30th of the 51 states that reported it. it reported 56.5 the year before on the same method, so this one moved 4.1 points up — the only one of the three where that comparison holds. either side of tennessee on that row: illinois at 60.7 and rhode island at 60.5.
the two blood tests
tennessee reported that 29.6 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 23rd of the 49 states that reported it, 0.5 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 57.0 percent and cholesterol 43.3 percent, both on 9,688 children — 16th of the 51 states that reported it on glucose, 9th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 40.3 percent. either side of tennessee on the both-tests row for ages 1 to 17: massachusetts at 40.6 and maine at 39.9.
the 30-day visit after a new adhd prescription
48.9 percent, on 12,340 children aged 6 to 12 who were newly prescribed an adhd medicine in tennessee — 21st of the 51 states that reported it, 1.3 points above the national median of 47.6. that leaves 51.1 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 56.2 percent had at least two more visits on 4,283 children, against a national median of 55.5 — 22nd of the 49 states that reported it. either side of tennessee on the 30-day row: montana at 49.1 and pennsylvania at 48.3.
what medicaid paid for in tennessee in 2024
in 2024 medicaid in tennessee paid for 171,893 hydroxyzine prescriptions, $2,372,498 worth, and 53,762 benzodiazepine prescriptions, $3,006,821 worth — 319.7 hydroxyzine prescriptions for every 100 benzodiazepine ones. 95 of the 362 hydroxyzine rows and 746 of the 1,414 benzodiazepine rows for tennessee 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 tennessee’s own numbers behind them
ask which drug it is, not which class
tennessee, 2024: 171,893 hydroxyzine prescriptions and 53,762 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
tennessee: 55.7 percent of children aged 1 to 11, 34th of the 50 states that reported it
in 44.3 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
tennessee: 29.6 percent of children aged 1 to 11 had both tests, 23rd of the 49 states that reported it
missed 70.4 percent of the time in tennessee. 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
tennessee: 48.9 percent, 21st of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and tennessee misses it 51.1 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 Tennessee, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Tennessee reported 55.7 percent for children aged 1 to 11, against a national median of 59.2 percent — 34th of the 50 states that reported it. For ages 12 to 17 it was 63.0 percent, and across ages 1 to 17 60.6 percent on 3,379 children.
In Tennessee, do children on antipsychotics get the blood tests?
29.6 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 23rd of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 57.0 percent, cholesterol 43.3 percent, on 9,688 children.
In Tennessee, how often does the 30-day ADHD follow-up visit happen?
48.9 percent of the time, on 12,340 children aged 6 to 12 newly prescribed an ADHD medicine — 21st of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 56.2 percent in Tennessee against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Tennessee rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 55.7 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 63.0 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 60.6 on a denominator of 3,379; APM-CH both blood tests, 1 to 11: 29.6 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 45.9 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 40.3 on a denominator of 9,688; APM-CH glucose alone, 1 to 17: 57.0 on a denominator of 9,688; APM-CH cholesterol alone, 1 to 17: 43.3 on a denominator of 9,688; ADD-CH 30-day adhd follow-up, 6 to 12: 48.9 on a denominator of 12,340; ADD-CH nine-month adhd follow-up, 6 to 12: 56.2 on a denominator of 4,283. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Tennessee rows, summed by product name, read 2026-09-28: hydroxyzine 171,893 prescriptions, $2,372,498, 95 of 362 rows suppressed; benzodiazepines 53,762 prescriptions, $3,006,821, 746 of 1,414 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