Monitoring Children Using ADHD Medication - Medicaid

12/14/2023

Medication for attention-deficit/hyperactivity disorder can help manage symptoms in children, according to the Centers for Disease Control and Prevention. Providers who prescribe ADHD medication to children should monitor them to ensure medications are prescribed and managed correctly, according to the National Committee for Quality Assurance. NCQA recommends following up with children who are newly prescribed ADHD medication and who remain on medication long term.

Supporting Quality Care

We track the NCQA quality measure Follow-Up Care for Children Prescribed ADHD Medication. This measure captures the percentage of children ages 6 to 12 who had:

  • Initiation phase: One follow-up visit with a provider with prescribing authority within 30 days of the first prescription
  • Continuation and maintenance phase: Two or more follow-up visits with a provider in the nine months (270 days) after the initiation phase. The child also remains on the ADHD medication for at least 210 days

Visits for both phases can be by telehealth when appropriate and depending on the member’s benefits.

For tips to close gaps in care for this measure, see our tip sheet.

Resources

For Texas Medicaid Provider Quality Improvement, review the following resources ranging from quality measures data to current vaccine schedules:

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.