children’s psychiatric drugs in wyoming medicaid: wyoming’s own three numbers
wyoming told cms three things about its children in the 2025 reporting year: 71.3 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 9th of the 50 states that reported it; 33.1 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 14th of the 49 states that reported it; 44.3 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 34th of the 51 states that reported it.[1]
across the whole age range, wyoming sits in the top quarter of the country on the two metabolic blood tests and below the national median on the 30-day adhd follow-up. same state, same year, same children.
every row wyoming sent to cms
| measure | wyoming | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 71.3 | withheld | 9 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 70.8 | withheld | 12 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 70.9 | 794 | 12 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 33.1 | withheld | 14 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 58.9 | withheld | 2 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 51.2 | 465 | 7 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 83.0 | 465 | 1 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 51.4 | 465 | 7 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 44.3 | 79 | 34 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | suppressed | withheld | — | 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, wyoming reported 71.3 percent — 12.1 points above the national median of 59.2, and 9th of the 50 states that reported it. put the other way round, 28.7 percent of the youngest children in wyoming who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 70.8 percent. across ages 1 to 17, 70.9 percent on 794 children, 12th of the 51 states that reported it. it reported 69.6 the year before on the same method, so this one moved 1.3 points up — the only one of the three where that comparison holds. either side of wyoming on that row: new hampshire at 71.0 and montana at 69.7.
the two blood tests
wyoming reported that 33.1 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 14th of the 49 states that reported it, 4.0 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 83.0 percent and cholesterol 51.4 percent, both on 465 children — the highest of the 51 states that reported it on glucose, 7th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 51.2 percent. either side of wyoming on the both-tests row for ages 1 to 17: delaware at 51.3 and arizona at 45.8.
the 30-day visit after a new adhd prescription
44.3 percent, on 79 children aged 6 to 12 who were newly prescribed an adhd medicine in wyoming — 34th of the 51 states that reported it, 3.3 points below the national median of 47.6. that leaves 55.7 percent of those children with no recorded prescriber visit in the month after the medicine started. Wyoming reported this measure for 2025, and CMS suppressed the cell: the nine-month continuation rate is not published because the number of children behind it is small enough that publishing it could identify them. That is a withheld number, not a zero. either side of wyoming on the 30-day row: south carolina at 44.4 and texas at 43.9.
what is missing from wyoming’s file, and why
- ADD-CH nine-month adhd follow-up, 6 to 12: Wyoming reported this measure for 2025, and CMS suppressed the cell: this cell is not published because the number of children behind it is small enough that publishing it could identify them. That is a withheld number, not a zero.
what medicaid paid for in wyoming in 2024
in 2024 medicaid in wyoming paid for 6,864 hydroxyzine prescriptions, $92,021 worth, and 4,378 benzodiazepine prescriptions, $83,796 worth — 156.8 hydroxyzine prescriptions for every 100 benzodiazepine ones. 82 of the 208 hydroxyzine rows and 448 of the 617 benzodiazepine rows for wyoming 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 wyoming’s own numbers behind them
ask which drug it is, not which class
wyoming, 2024: 6,864 hydroxyzine prescriptions and 4,378 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
wyoming: 71.3 percent of children aged 1 to 11, 9th of the 50 states that reported it
in 28.7 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
wyoming: 33.1 percent of children aged 1 to 11 had both tests, 14th of the 49 states that reported it
missed 66.9 percent of the time in wyoming. 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
wyoming: 44.3 percent, 34th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and wyoming misses it 55.7 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 Wyoming, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Wyoming reported 71.3 percent for children aged 1 to 11, against a national median of 59.2 percent — 9th of the 50 states that reported it. For ages 12 to 17 it was 70.8 percent, and across ages 1 to 17 70.9 percent on 794 children.
In Wyoming, do children on antipsychotics get the blood tests?
33.1 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 14th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 83.0 percent, cholesterol 51.4 percent, on 465 children.
In Wyoming, how often does the 30-day ADHD follow-up visit happen?
44.3 percent of the time, on 79 children aged 6 to 12 newly prescribed an ADHD medicine — 34th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was not published for Wyoming.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Wyoming rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 71.3 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 70.8 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 70.9 on a denominator of 794; APM-CH both blood tests, 1 to 11: 33.1 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 58.9 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 51.2 on a denominator of 465; APM-CH glucose alone, 1 to 17: 83.0 on a denominator of 465; APM-CH cholesterol alone, 1 to 17: 51.4 on a denominator of 465; ADD-CH 30-day adhd follow-up, 6 to 12: 44.3 on a denominator of 79; ADD-CH nine-month adhd follow-up, 6 to 12: DS, data suppressed. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Wyoming rows, summed by product name, read 2026-09-28: hydroxyzine 6,864 prescriptions, $92,021, 82 of 208 rows suppressed; benzodiazepines 4,378 prescriptions, $83,796, 448 of 617 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