children’s psychiatric drugs in vermont medicaid: vermont’s own three numbers
vermont told cms three things about its children in the 2025 reporting year: 83.5 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, the highest of the 50 states that reported it; 37.1 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 9th of the 49 states that reported it; 60.6 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, the third-highest of the 51 states that reported it.[1]
across the whole age range, vermont sits in the top quarter of the country on the 30-day adhd follow-up and above the national median on the two metabolic blood tests. same state, same year, same children.
every row vermont sent to cms
| measure | vermont | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 83.5 | withheld | 1 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 75.7 | withheld | 6 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 78.2 | 262 | 5 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 37.1 | withheld | 9 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 37.6 | withheld | 23 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 37.4 | 705 | 17 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 56.5 | 705 | 17 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 39.9 | 705 | 16 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 60.6 | 960 | 3 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 61.7 | 640 | 9 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, vermont reported 83.5 percent — 24.3 points above the national median of 59.2, and the highest of the 50 states that reported it. put the other way round, 16.5 percent of the youngest children in vermont who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 75.7 percent. across ages 1 to 17, 78.2 percent on 262 children, the fifth-highest of the 51 states that reported it. it reported 74.5 the year before on the same method, so this one moved 3.7 points up — the only one of the three where that comparison holds. either side of vermont on that row: district of columbia at 78.5 and ohio at 75.6.
the two blood tests
vermont reported that 37.1 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 9th of the 49 states that reported it, 8.0 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 56.5 percent and cholesterol 39.9 percent, both on 705 children — 17th of the 51 states that reported it on glucose, 16th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 37.4 percent. either side of vermont on the both-tests row for ages 1 to 17: new hampshire at 37.4 and california at 37.2.
the 30-day visit after a new adhd prescription
60.6 percent, on 960 children aged 6 to 12 who were newly prescribed an adhd medicine in vermont — the third-highest of the 51 states that reported it, 13.0 points above the national median of 47.6. that leaves 39.4 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 61.7 percent had at least two more visits on 640 children, against a national median of 55.5 — 9th of the 49 states that reported it. either side of vermont on the 30-day row: west virginia at 62.8 and arizona at 58.8.
what medicaid paid for in vermont in 2024
in 2024 medicaid in vermont paid for 20,221 hydroxyzine prescriptions, $263,630 worth, and 34,661 benzodiazepine prescriptions, $455,904 worth — 58.3 hydroxyzine prescriptions for every 100 benzodiazepine ones. 76 of the 246 hydroxyzine rows and 475 of the 868 benzodiazepine rows for vermont 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 vermont’s own numbers behind them
ask which drug it is, not which class
vermont, 2024: 20,221 hydroxyzine prescriptions and 34,661 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
vermont: 83.5 percent of children aged 1 to 11, the highest of the 50 states that reported it
in 16.5 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
vermont: 37.1 percent of children aged 1 to 11 had both tests, 9th of the 49 states that reported it
missed 62.9 percent of the time in vermont. 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
vermont: 60.6 percent, the third-highest of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and vermont misses it 39.4 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 Vermont, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Vermont reported 83.5 percent for children aged 1 to 11, against a national median of 59.2 percent — the highest of the 50 states that reported it. For ages 12 to 17 it was 75.7 percent, and across ages 1 to 17 78.2 percent on 262 children.
In Vermont, do children on antipsychotics get the blood tests?
37.1 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 9th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 56.5 percent, cholesterol 39.9 percent, on 705 children.
In Vermont, how often does the 30-day ADHD follow-up visit happen?
60.6 percent of the time, on 960 children aged 6 to 12 newly prescribed an ADHD medicine — the third-highest of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 61.7 percent in Vermont against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Vermont rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 83.5 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 75.7 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 78.2 on a denominator of 262; APM-CH both blood tests, 1 to 11: 37.1 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 37.6 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 37.4 on a denominator of 705; APM-CH glucose alone, 1 to 17: 56.5 on a denominator of 705; APM-CH cholesterol alone, 1 to 17: 39.9 on a denominator of 705; ADD-CH 30-day adhd follow-up, 6 to 12: 60.6 on a denominator of 960; ADD-CH nine-month adhd follow-up, 6 to 12: 61.7 on a denominator of 640. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Vermont rows, summed by product name, read 2026-09-28: hydroxyzine 20,221 prescriptions, $263,630, 76 of 246 rows suppressed; benzodiazepines 34,661 prescriptions, $455,904, 475 of 868 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