All states (including the District of Columbia) are required to provide data to The Centers for Medicare & Medicaid Services (CMS) on a range of indicators related to key application, eligibility, and enrollment processes within the state Medicaid and Children’s Health Insurance Programs (CHIP). These data reflect enrollment activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, as well as state program performance.

This data set includes monthly counts and rates (per 1,000 beneficiaries) of behavioral health services, including emergency department services, inpatient services, intensive outpatient/partial hospitalizations, outpatient services, or services delivered through telehealth, provided to Medicaid and CHIP beneficiaries, by state. Users can filter by either mental health disorder or substance use disorder.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating behavioral health services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Claims Volume - IP, Claims Volume - OT, Diagnosis Code - IP, Diagnosis Code - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

2016-2019. This dataset is a de-identified summary table of prevalence rates for vision and eye health data indicators from the Medicaid Analytic eXtract (MAX) data. Medicaid MAX are a set of de-identified person-level data files with information on Medicaid eligibility, service utilization, diagnoses, and payments. The MAX data contain a convenience sample of claims processed by Medicaid and Children’s Health Insurance Program (CHIP) fee for service and managed care plans. Not all states are included in MAX in all years, and as of November 2019, 2014 data is the latest available. Prevalence estimates are stratified by all available combinations of age group, gender, and state. Detailed information on VEHSS Medicare analyses can be found on the VEHSS Medicaid MAX webpage (cdc.gov/visionhealth/vehss/data/claims/medicaid.html). Information on available Medicare claims data can be found on the ResDac website (www.resdac.org). The VEHSS Medicaid MAX dataset was last updated May 2023.

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by program type (Medicaid or CHIP).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topics Medicaid-only Enrollment and M-CHIP and S-CHIP Enrollment. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set includes monthly counts and percentages of Medicaid and CHIP beneficiaries, by state, who received at least one service for each of the following conditions: acute bronchitis, acute respiratory distress, bronchitis not other specified (NOS), COVID-19 (based on the presence of diagnosis code U07.1), influenza, lower or acute respiratory infection, pneumonia, respiratory infection NOS, and suspected COVID-19 (based on the presence of diagnosis code B97.29).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating COVID-related conditions measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Claims Volume - IP, Claims Volume - OT, Claims Volume - IP, Diagnosis Code - IP, Diagnosis Code - OT, Procedure Codes - OT Professional. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This table presents beneficiaries who received a service for a physical health condition among beneficiaries who received a service for a substance use disorder, by physical health condition, 2017-2021.

Some states have serious data quality issues, making the data unusable for identifying this population. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state are considered unusable based on DQ Atlas thresholds for the following topics: Total Medicaid and CHIP Enrollment, Claims Volume - IP, Claims Volume - OT, Claims Volume - IP, Diagnosis Code - IP, Diagnosis Code - OT, Procedure Codes - OT Professional, Gender, Age, Zip code, Race and ethnicity, Eligibility group code, Enrollment in CMC Plans.

Data from Maryland, Tennessee, and Utah are omitted for the tables due to data quality concerns. Maryland was excluded in 2017 due to unusable diagnosis codes in the IP file and the OT file. Tennessee was excluded due to unusable diagnosis codes in the IP file in 2017 - 2019. Utah was excluded due to unusable procedure codes on OT professional claims in 2017 - 2020. In addition, states with a high data quality concern on one or more measures are noted in the table in the "Data Quality" column. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each managed care plan type over the year (duplicated count); (2) the number of beneficiaries enrolled in each managed care plan type as of an individual’s last month of enrollment (duplicated count); and (3) average monthly enrollment in each managed care plan type.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some cells have a value of “DS”. Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by dual eligibility status for Medicaid and Medicare (full dual eligibility, partial dual eligibility, or not dually eligible). There are three metrics presented: (1) the number of beneficiaries ever dually eligible for Medicaid and Medicare over the year (duplicated count); (2) the number of beneficiaries dually eligible for Medicaid and Medicare as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly eligibility for Medicaid and Medicare.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Dually Enrolled in Medicare. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by dual eligibility status for Medicaid and Medicare (full dual eligibility, partial dual eligibility, or not dually eligible).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Dually Enrolled in Medicare. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by benefit package (full-scope, comprehensive, limited, or unknown). There are three metrics presented: (1) the number of beneficiaries ever enrolled with each benefit package over the year (duplicated count); (2) the number of beneficiaries enrolled with each benefit package as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment with each benefit package.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Restricted Benefits Code. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.