Table 132Medicaid beneficiaries and expenditures for people with a mental health or substance use disorder diagnosis, including prescription medication expenditures, by diagnostic category and age group: number and expenditures, United States, 2010

[Data are based on a household survey of a nationally representative sample]

Diagnostic categoryAll agesAged 17 or youngerAged 18 or older
Number of beneficiariesTotal behavioral health expenditures (millions of dollars)Average behavioral health expenditures per beneficiary (dollars)Number of beneficiariesTotal behavioral health expenditures (millions of dollars)Average behavioral health expenditures per beneficiary (dollars)Number of beneficiariesTotal behavioral health expenditures (millions of dollars)Average behavioral health expenditures per beneficiary (dollars)
Any mental health disorder7,977,606$10,628$1,3322,207,443$3,765$1,7055,770,163$6,864$1,189
 Anxiety disorders2,465,2141,682682274,313**2,190,9011,526697
 Attention-deficit/hyperactivity disorder and other disruptive behavior disorders2,097,1543,3161,5811,748,8122,5691,469348,3427472,144
 Mood disorders14,070,1534,039992348,988**3,721,1653,473933
 Schizophrenia and other psychotic disorders393,1861,1322,878***363,7461,0262,822
 Miscellaneous disorders2434,7464601,057202,495**232,25191392
Any substance use disorder220,3783301,496****180*
*

Estimates are considered unreliable because of low precision.

1

Mood disorders include bipolar disorders and depressive disorders.

2

Miscellaneous disorders include disorders coded as diagnosed in infancy (5.6) and miscellaneous mental disorders (5.15).

NOTES: Mental health diagnosis is defined as at least one Medicaid reimbursed expenditure with one of the following Clinical Classifications Software (CCS) codes: anxiety disorders (651), attention deficit and conduct disorders (652), mood disorders (657), schizophrenia and other psychotic disorders (659), or other mental health disorders (650, 655, 656, 658, 670). CCS codes that were excluded from mental health diagnosis include delirium, dementia, and other cognitive disorders (653); developmental disorders (654); and suicide and self-inflicted injury (662). Substance abuse diagnosis is defined as at least one Medicaid reimbursed expenditure with one of the following CCS codes: alcohol-related disorders (660) and drug use disorders (661). Expenditures for dental services, durable medical equipment, and home health services are excluded. All prescription medications are included, regardless of medical condition for which they are prescribed. For each age category, average behavioral health expenditure per beneficiary is calculated by dividing total behavioral health expenditures by the number of beneficiaries.

Utilization and expenditure estimates derived from the Medical Expenditure Panel Survey (MEPS) often differ from estimates derived from other sources. For example, people residing in a psychiatric facility are not included in the MEPS sample, whereas they are usually included in administrative claims data. For more details, see Bernard et al. (2012).

Expenditure estimates were adjusted from 2010 to 2012 dollars using the GDP Price Index. The index is compiled by the U.S. Department of Commerce's Bureau of Economic Analysis.

As an example of how to interpret the estimates in the table, in 2010, the average behavioral health expenditure (including prescription medication expenditures) per Medicaid beneficiary with a mental health diagnosis was $1,332 ($10.6 million total expenditures / 8 million beneficiaries), and the average behavioral health expenditure (including prescription medication expenditures) per Medicaid beneficiary aged 17 or younger with a mental health diagnosis was $1,705 ($3.8 million total expenditures / 2.2 million beneficiaries).

SOURCE: Medical Expenditure Panel Survey. Agency for Healthcare Research and Quality; 2010. .

From: 5, TABLES

Cover of Behavioral Health, United States, 2012
Behavioral Health, United States, 2012.

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