The following table provides eligibility levels in each state for key coverage groups that use Modified Adjusted Gross Income (MAGI), as of April 1, 2018. The data represent the principal, but not all, MAGI coverage groups in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). All income standards are expressed as a percentage of the federal poverty level (FPL). The MAGI-based rules generally include adjusting an individual’s income by an amount equivalent to a 5% FPL disregard. Other eligibility criteria also apply, such as citizenship, immigration status, and state residency.

For more information, see:
https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html

This data set includes monthly counts and rates (per 1,000 beneficiaries) of COVID-19 testing services provided to Medicaid and CHIP beneficiaries, by state.

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-19 testing 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, Procedure Codes - OT Professional, Claims Volume - 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.

This table presents beneficiaries who received at least one behavioral health service, by behavioral 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 table presents the number of beneficiaries with a delivery, the number of beneficiaries with any SMM condition, and the rate of SMM conditions per 10,000 deliveries, 2017 - 2021.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues, making the data unusable for identifying this population. 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. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

Data from Maryland, Tennessee, and Utah are omitted from 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 includes monthly counts and rates (per 1,000 beneficiaries) of perinatal care, including prenatal visits, prenatal bundled payments, postpartum visits, and postpartum bundled payments, for female Medicaid and CHIP beneficiaries ages 15 to 44 (as of the first day of the month), by state.

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 perinatal care 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, Procedure Codes - OT Professional, Claims Volume - 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.

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-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 Eligibility Group 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.

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 presents annual enrollment counts of Medicaid and CHIP beneficiaries by program type (Medicaid or CHIP). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each program type over the year (duplicated count); (2) the number of beneficiaries enrolled in each program type as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment in each program type.

These metrics are based on data in the T-MSIS Analytic Files (TAF). 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 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 data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by benefit package (full-scope, comprehensive, limited, or unknown).

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.