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
Current Medicaid & CHIP Enrollment
Medicaid Spending
- Total Medicaid Spending
- Distribution of Medicaid Spending by Service
- 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 Per Enrollee
Demographic and Health Status Characteristics of Medicaid Enrollees
- Medicaid Enrollees by Enrollment Group
- Full-Benefit Medicaid Enrollees by Enrollment Group
- Medicaid Enrollees by Age
- Medicaid Enrollees by Sex
- Medicaid Enrollees by Race/Ethnicity
- Medicaid Enrollees by Urban/Rural Status
- Medicaid Enrollees Ages 19-64 by Number of Diagnosed Chronic Conditions
- Share of Children with Medicaid/CHIP Who Have Special Health Care Needs
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, 2000-2025
- Medicaid Income Eligibility Limits for Infants Ages 0 – 1, 2000-2025
- Medicaid Income Eligibility Limits for Children Ages 1 – 5, 2000-2025
- Medicaid Income Eligibility Limits for Children Ages 6 – 18, 2000-2025
- Separate Children’s Health Insurance Program (CHIP) Income Eligibility Limits for Children, 2000-2025
Medicaid Eligibility for Seniors, People with Disabilities, and the Medically Needy
- Medicaid Eligibility for SSI Enrollees and Optional Seniors & People with Disabilities Up To 100% FPL
- Medicaid Eligibility for Medically Needy Populations
- Medicaid Eligibility through Buy-In Programs for Working People with Disabilities
- Medicaid Eligibility Through the Family Opportunity Act for Children with Disabilities Up to 300% FPL
- Medicaid Eligibility for Katie Beckett Children with Significant Disabilities and Special Income Rule
- State Adoption of Key Medicaid Eligibility Pathways Based on Old Age or Disability
Application and Enrollment Systems
Streamlined Enrollment & Renewal Practices
- Actions to Increase Ex Parte Renewal Rates in the Past Year
- Select Policy Options in CHIP
- Adoption or Continuation of Policies Allowed As 1902(e)(14)(A) Waivers During Unwinding
- State Adoption of Procedures to Streamline Renewals for Seniors and People with Disabilities
- Suspension of Medicaid Coverage for Incarcerated Adults
- Presumptive Eligibility
Births Financed by Medicaid
Coverage under the Medicaid Expansion
SSDI/SSI Beneficiaries
- Total SSDI Beneficiaries and SSI Beneficiaries, Under Age 65
- Total SSDI Beneficiaries and SSI Beneficiaries as a Percent of Population Under Age 65
- Age Distribution of Disabled Workers Under 65 in the SSDI Program
- Age and Sex Distribution of Disabled Workers Under 65 in the SSDI Program
- Distribution of SSI Beneficiaries by Age
- Average Monthly Benefits for SSDI and SSI Beneficiaries
- Distribution of SSDI Beneficiaries by Diagnostic Group
- Distribution of SSI Beneficiaries Under 65 by Diagnostic Group
Dual-Eligible Individuals
- Number of Dual-Eligible Individuals
- Number of Dual-Eligible Individuals by Age
- Dual-Eligible Individuals as a Share of Medicaid Enrollment
- Dual-Eligible Individuals as a Share of Medicaid Enrollment by Age
- Medicaid Spending Per Dual-Eligible Individual
- Medicaid Spending For Dual-Eligible Individuals As A Share of Total Medicaid Spending
- Number of Full-Benefit Dual-Eligible Individuals by Age
- Number of Partial-Benefit Dual-Eligible Individuals by Age
- Full-benefit Dual-Eligible Individuals, by Medicare and Medicaid Coverage Arrangements
- Full-benefit Dual-Eligible Individuals, by Medicaid Coverage Arrangements
- Full-benefit Dual-Eligible Individuals, by Number of Medicaid Service Delivery Systems
Medicaid Physician Fees
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
Long-Term Care
- Medicaid Enrollees Using Home Care Services (HCBS)
- Medicaid Enrollees Using Institutional Long-Term Care (LTC)
- Medicaid Enrollees Using Long-Term Care (LTC) as a Percent of Full-Benefit Medicaid Enrollees
- Medicaid Spending per Enrollee Using Long-Term Care (LTC)
- Number of People Waiting for Medicaid Home Care (HCBS), by Target Population and Whether States Screen for Eligibility
Medicaid and CHIP Participation Rates
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
- States With At Least One Provider Tax in Place
- States With a Hospital Provider Tax in Place
- States With a Nursing Facility Provider Tax in Place
- States With an Intermediate Care Facility for Those With Intellectual Disabilities (ICF-IDs) Provider Tax in Place
- States With an MCO Provider Tax in Place
- States With an Ambulance Provider Tax in Place
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
Substance Use Disorder (SUD) Services
- Medicaid Behavioral Health Services: ASAM Level 0.5 – Early Intervention
- Medicaid Behavioral Health Services: ASAM Level 1 – Outpatient Treatment
- Medicaid Behavioral Health Services: ASAM Level 2.1 – Intensive Outpatient Treatment (IOT)
- Medicaid Behavioral Health Services: ASAM Level 2.5 – Partial Hospitalization Services
- Medicaid Behavioral Health Services: ASAM Level 3.1 Clinically Managed Low-Intensity Residential Services
- Medicaid Behavioral Health Services: ASAM Level 3.3 – Clinicially Managed Population-Specific High Intensity Residential Services
- Medicaid Behavioral Health Services: ASAM Level 3.5 – Clinically Managed Medium-/High-Intensity Residential Services
- Medicaid Behavioral Health Services: ASAM Level 3.7: Medically Monitored Intensive Inpatient Services
- Medicaid Behavioral Health Services: ASAM Level 4 – Medically Managed Intensive Inpatient Treatment
- Medicaid Behavioral Health Services: Outpatient Detoxification
- Medicaid Behavioral Health Services: Oral Naltrexone for Medication Assisted Treatment (MAT)
- Medicaid Behavioral Health Services: Injectable Naltrexone for Medication Assisted Treatment (MAT)
- Medicaid Behavioral Health Services: Methadone for Medication Assisted Treatment (MAT)
- Medicaid Behavioral Health Services: Oral Buprenorphine for Medication Assisted Treatment (MAT)
- Medicaid Behavioral Health Services: Injectable Buprenorphine for Medication Assisted Treatment (MAT)
- Medicaid Behavioral Health Services: Suboxone Treatment
- Medicaid Behavioral Health Services: Smoking and Tobacco Use Cessation Counseling (Excluding Mandatory Coverage for Pregnant Women)
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)