Medicaid & CHIP
This category provides information about Medicaid and the Children's Health Insurance Program (CHIP), states’ health coverage programs for low-income children and adults. It includes topics such as enrollment, eligibility requirements, covered benefits, spending and federal matching amounts, managed care participation, home and community-based services, and Medicaid waivers. Information on Medicaid pharmacy policies and administration is provided in a separate data collection.
Select an indicator below to view state data. Results will be shown as a table, map, or trend graph, as available. To compile data from multiple indicators for one or more states, build a Custom State Report.
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Medicaid & CHIP Indicators
Medicaid Spending
- Total Medicaid Spending
- Distribution of Medicaid Spending by Service
- Medicaid Expansion Spending
- Distribution of Fee-for-Service Medicaid Spending on Acute Care
- Distribution of Fee-for-Service Medicaid Spending on Long Term Care
- Federal and State Share of Medicaid Spending
- Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier
- Federal Medicaid Disproportionate Share Hospital (DSH) Allotments
Medicaid Spending and Enrollment by Enrollment Group
Current Medicaid & CHIP Enrollment
Coverage under the Medicaid Expansion
Medicaid and CHIP Participation Rates
Medicaid 12-Month Continuous Eligibility Policies
Medicaid/CHIP Eligibility Limits
- Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level
- Medicaid and CHIP Income Eligibility Limits for Children as a Percent of the Federal Poverty Level
- Medicaid and CHIP Income Eligibility Limits for Pregnant Women as a Percent of the Federal Poverty Level
- Medicaid/CHIP Coverage of Lawfully-Residing Immigrant Children and Pregnant Women
Trends in Medicaid Income Eligibility Limits
Trends in Income Eligibility Limits for Adults
Trends in Income Eligibility Limits for Children
- Medicaid/CHIP Upper Income Eligibility Limits for Children, 2000-2023
- Medicaid Income Eligibility Limits for Infants Ages 0 – 1, 2000-2023
- Medicaid Income Eligibility Limits for Children Ages 1 – 5, 2000-2023
- Medicaid Income Eligibility Limits for Children Ages 6 – 18, 2000-2023
- Separate Children’s Health Insurance Program (CHIP) Income Eligibility Limits for Children, 2000-2023
Medicaid Eligibility for Seniors, People with Disabilities, and the Medically Needy
- Medicaid Eligibility through the Aged, Blind, Disabled Pathway
- Medicaid Eligibility through the Medically Needy Pathway
- Medicaid Eligibility through Buy-In Programs for Working People with Disabilities
- Medicaid Eligibility for Long-Term Care Through the Special Income Rule
- State Adoption of Major Optional Pathways to Full Medicaid Eligibility Based on Old Age or Disability
Application and Enrollment Systems
Streamlined Enrollment & Renewal Practices
- State Approaches to the Unwinding Period
- Staff Responsible for Processing Applications and Renewals in Medicaid and CHIP
- Modes of Renewing Medicaid Applications
- State Adoption of Selected ACA Medicaid Eligibility and Renewal Provisions for Aged/Disabled Population
- Medicaid Ex-Parte Renewals
- State Follow-Up on Returned Mail
- Medicaid Renewal Communications When Continuous Enrollment Provision Ends
Premium & Cost-Sharing Requirements
- Premiums, Enrollment Fees, and Cost-Sharing Requirements for Children
- Cost-Sharing Amounts for Selected Services for Children at Selected Income Levels
- Cost-Sharing Amounts for Prescription Drugs for Children at Selected Income Levels
- Cost-Sharing Requirements for Selected Medicaid Services for Section 1931 Parents
- Premium and Cost-Sharing Requirements for Selected Services for Medicaid Adults
Medicaid Beneficiaries
Medicaid Physician Fees
SSI Beneficiaries
Medicare-Medicaid Enrollees
Medicaid Managed Care Market Tracker
Medicaid MCO State-Level Enrollment Data
Medicaid MCO-Level Data
Medicaid MCO Parent Firm-Level Data
Medicaid MCO State-Level Spending Data
Medicaid MCO State-Level Access Standards & Contract Requirements
- Medicaid Managed Care Quality Initiatives
- Performance Measure Focus Areas for Medicaid Managed Care Incentives
- States Reporting Medicaid Managed Care Requirements for Alternative Provider Payment Models (APMs)
- States Reporting Social Determinant of Health Related Policies Required in Medicaid Managed Care Contracts
Births Financed by Medicaid
Home and Community-Based Services
- Medicaid HCBS Spending, By Authority ($, in thousands)
- People Receiving Medicaid HCBS, by Authority
- Medicaid Section 1915 (c) HCBS Waiver Spending, by Target Population
- Medicaid Section 1915(c) HCBS Waiver Participants, by Type of Waiver
- Medicaid HCBS Waiver Waiting List Enrollment, by Target Population and Whether States Screen for Eligibility
- Medicaid HCBS Spending Per Person, By Authority
- Average Provider Reimbursement Rates for Home Health and Personal Care State Plan Services
- State Financial Eligibility Criteria for Medicaid HCBS Waivers by Target Population
Children's Health Insurance Program (CHIP)
Opioids-Related Medicaid Policies
Medicaid Coverage of Preventive Services
Delivery System Reform Incentive Payment Program (DSRIP)
Medicaid Policy Action Trends
Medicaid Eligibility Changes
Medicaid Benefit Changes
Medicaid Provider Rate Changes
Medicaid Provider Taxes or Fees
Medicaid Benefits
Institutional and Clinic Services
- Medicaid Benefits: Inpatient Hospital Services, other than in an Institution for Mental Disease
- Medicaid Benefits: Outpatient Hospital Services
- Medicaid Benefits: Rural Health Clinic Services
- Medicaid Benefits: Federally Qualified Health Center Services
- Medicaid Benefits: Clinic Services (Excluding Mandatory FQHC and RHC Services)
- Medicaid Benefits: Freestanding Birth Center Services
Practitioner Services
- Medicaid Benefits: Physician Services
- Medicaid Benefits: Medical/Surgical Services of a Dentist
- Medicaid Benefits: Nurse Midwife Services
- Medicaid Benefits: Nurse Practitioner Services
- Medicaid Benefits: Dental Services
- Medicaid Benefits: Podiatrist Services
- Medicaid Benefits: Optometrist Services
- Medicaid Benefits: Chiropractor Services
- Medicaid Benefits: Psychologist Services
Prescription Drugs
Physical Therapy and Other Services
Products and Devices
Transportation Services
Other Services
- Medicaid Benefits: Laboratory and X-Ray Services, outside Hospital or Clinic
- Medicaid Benefits: Family Planning Services
- Medicaid Benefits: Diagnostic, Screening and Preventive Services
- Medicaid Benefits: Rehabilitation Services – Mental Health and Substance Use
- Medicaid Benefits: Case Management
- Medicaid Benefits: Targeted Case Management
- Medicaid Benefits: ACA Health Home
- Medicaid Benefits: Other Medical or Remedial Care – Hygienists or Dental Assistants
- Medicaid Benefits: Other Medical or Remedial Care – Physician Assistants
Long-Term Care: Home and Community Based Care
- Medicaid Benefits: Home Health Services – Nursing Services, Home Health Aides, and Medical Supplies/Equipment
- Medicaid Benefits: Home Health Services – Physical Therapy, Occupational Therapy, and/or Speech Pathology/Audiology
- Medicaid Benefits: Private Duty Nursing Services
- Medicaid Benefits: Hospice Care
- Medicaid Benefits: Personal Care Services
- Medicaid Benefits: Self-Directed Personal Assistance Services
- Medicaid Benefits: Program of All-Inclusive Care for the Elderly (PACE)
Long-Term Care: Institutional Care
Medicaid Behavioral Health Services
Institutional Care and Intensive Services
Outpatient Facility Services and/or Provider Services
- Medicaid Behavioral Health Services: Case Management
- Medicaid Behavioral Health Services: Day Treatment
- Medicaid Behavioral Health Services: Partial Hospitalization
- Medicaid Behavioral Health Services: Psychosocial Rehabilitation (e.g. “Clubhouse model”)
- Medicaid Behavioral Health Services: Intensive Outpatient Treatment
- Medicaid Behavioral Health Services: Mental Health Rehabilitation
- Medicaid Behavioral Health Services: ADL/Skills Training
- Medicaid Behavioral Health Services: Assertive Community Treatment
- Medicaid Behavioral Health Services: Psychiatric Services – Evaluation
- Medicaid Behavioral Health Services: Psychiatric Services – Testing
- Medicaid Behavioral Health Services: Psychological Testing
- Medicaid Behavioral Health Services: Individual Therapy
- Medicaid Behavioral Health Services: Group Therapy
- Medicaid Behavioral Health Services: Family Therapy
Naloxone (Without Prior Authorization)
- Medicaid Behavioral Health Services: Naloxone Available in at Least One Formulation Without Prior Authorization
- Medicaid Behavioral Health Services: Naloxone Nasal Spray Covered Without Prior Authorization
- Medicaid Behavioral Health Services: Naloxone Nasal Spray Atomizer Covered Without Prior Authorization
- Medicaid Behavioral Health Services: Naloxone Coverage Provided for Family Members or Friends Obtaining a Naloxone Prescription on Enrollee’s Behalf
Crisis Services
Integrated Care
- Medicaid Behavioral Health Services: Collaborative Care Model Services
- Medicaid Behavioral Health Services: Health Behavior Assessment and Intervention (HBAI) Services
- Medicaid Behavioral Health Services: Health Home Services
- Medicaid Behavioral Health Services: Medicaid Individual Counseling or Family Counseling Services
- Medicaid Behavioral Health Services: Medicaid Psychiatric Evaluation With Medical Services
- Medicaid Behavioral Health Services: Medicaid Psychiatric Evaluation Without Medical Services (Non-Face to Face)
- Medicaid Behavioral Health Services: Mental Health Screening in Primary Care
- Medicaid Behavioral Health Services: Screening, Brief Intervention, and Referral to Treatment (SBIRT)