children’s psychiatric drugs in west virginia medicaid: west virginia’s own three numbers
west virginia told cms three things about its children in the 2025 reporting year: 52.4 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 42nd of the 50 states that reported it; 58.7 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, the fifth-highest of the 49 states that reported it; 62.8 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, the second-highest of the 51 states that reported it.[1]
across the whole age range, west virginia sits in the top quarter of the country 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 west virginia sent to cms
| measure | west virginia | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 52.4 | withheld | 42 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 51.1 | withheld | 47 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 51.5 | 1,072 | 47 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 58.7 | withheld | 5 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 60.2 | withheld | 1 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 59.7 | 2,393 | 1 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 75.3 | 2,393 | 2 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 60.6 | 2,393 | 1 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 62.8 | 3,523 | 2 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 62.5 | 1,436 | 6 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, west virginia reported 52.4 percent — 6.8 points below the national median of 59.2, and 42nd of the 50 states that reported it. put the other way round, 47.6 percent of the youngest children in west virginia who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 51.1 percent. across ages 1 to 17, 51.5 percent on 1,072 children, the fifth-lowest of the 51 states that reported it. it reported 49.0 the year before on the same method, so this one moved 2.5 points up — the only one of the three where that comparison holds. either side of west virginia on that row: delaware at 53.3 and idaho at 50.1.
the two blood tests
west virginia reported that 58.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fifth-highest of the 49 states that reported it, 29.6 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 75.3 percent and cholesterol 60.6 percent, both on 2,393 children — the second-highest of the 51 states that reported it on glucose, the highest of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 59.7 percent. either side of west virginia on the both-tests row for ages 1 to 17: maryland at 58.1.
the 30-day visit after a new adhd prescription
62.8 percent, on 3,523 children aged 6 to 12 who were newly prescribed an adhd medicine in west virginia — the second-highest of the 51 states that reported it, 15.2 points above the national median of 47.6. that leaves 37.2 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 62.5 percent had at least two more visits on 1,436 children, against a national median of 55.5 — 6th of the 49 states that reported it. either side of west virginia on the 30-day row: maryland at 64.2 and vermont at 60.6.
a break in west virginia’s own series, not a collapse in care
west virginia reported 32.1 on 30-day adhd follow-up, 6 to 12 in the 2024 reporting year and 62.8 in 2025, a move of 30.7 points. west virginia reported 35.6 on nine-month adhd follow-up, 6 to 12 in the 2024 reporting year and 62.5 in 2025, a move of 26.9 points. between those two years every reporting state in the country switched these measures from claims data to electronic clinical data systems, so the instrument changed underneath the numbers. moves that size are a change in how the counting was done before they are anything about clinics in west virginia, and we are not going to read them as one. every state where this happened.
what medicaid paid for in west virginia in 2024
in 2024 medicaid in west virginia paid for 127,523 hydroxyzine prescriptions, $1,734,412 worth, and 147,311 benzodiazepine prescriptions, $1,800,898 worth — 86.6 hydroxyzine prescriptions for every 100 benzodiazepine ones. 51 of the 309 hydroxyzine rows and 386 of the 1,050 benzodiazepine rows for west virginia 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 west virginia’s own numbers behind them
ask which drug it is, not which class
west virginia, 2024: 127,523 hydroxyzine prescriptions and 147,311 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
west virginia: 52.4 percent of children aged 1 to 11, 42nd of the 50 states that reported it
in 47.6 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
west virginia: 58.7 percent of children aged 1 to 11 had both tests, the fifth-highest of the 49 states that reported it
missed 41.3 percent of the time in west virginia. 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
west virginia: 62.8 percent, the second-highest of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and west virginia misses it 37.2 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 West Virginia, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year West Virginia reported 52.4 percent for children aged 1 to 11, against a national median of 59.2 percent — 42nd of the 50 states that reported it. For ages 12 to 17 it was 51.1 percent, and across ages 1 to 17 51.5 percent on 1,072 children.
In West Virginia, do children on antipsychotics get the blood tests?
58.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fifth-highest of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 75.3 percent, cholesterol 60.6 percent, on 2,393 children.
In West Virginia, how often does the 30-day ADHD follow-up visit happen?
62.8 percent of the time, on 3,523 children aged 6 to 12 newly prescribed an ADHD medicine — the second-highest of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 62.5 percent in West Virginia against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, West Virginia rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 52.4 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 51.1 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 51.5 on a denominator of 1,072; APM-CH both blood tests, 1 to 11: 58.7 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 60.2 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 59.7 on a denominator of 2,393; APM-CH glucose alone, 1 to 17: 75.3 on a denominator of 2,393; APM-CH cholesterol alone, 1 to 17: 60.6 on a denominator of 2,393; ADD-CH 30-day adhd follow-up, 6 to 12: 62.8 on a denominator of 3,523; ADD-CH nine-month adhd follow-up, 6 to 12: 62.5 on a denominator of 1,436. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, West Virginia rows, summed by product name, read 2026-09-28: hydroxyzine 127,523 prescriptions, $1,734,412, 51 of 309 rows suppressed; benzodiazepines 147,311 prescriptions, $1,800,898, 386 of 1,050 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