Analysis of Allowed and Paid Claims for Substance Use Disorder in 2023-2024
Explore the data on allowed and paid claims for Substance Use Disorder (SUD) in 2023-2024, including breakdowns by depression and anxiety, with detailed costs and averages. Gain insights into the trends and costs associated with SUD treatment over the specified period.
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Allowed and Paid Claims 2023-2024 Q3 Mental Illness vs Substance Use Disorder Rate and Form Compliance Division Commissioner Vicki Schmidt Director Julie Holmes Anthony Depner Research Analyst 6/10/2025
Query Information Data pulled from 2023 through the third quarter of 2024. This data is comprised of any claim that had a diagnosis code matching a substance use disorder or mental illness code listed on the following slides. The data is separated between mental health and substance use disorder, with further breakdown between diagnosis codes for depression and anxiety. 2
Codes for Substance Use Disorder The codes used to query substance use disorder (SUD) are as follows: Any ICD-10 code between F10-F16 Any ICD-10 code between F18-F19 Any ICD-9 code between 303-305.03 Any ICD-9 code between 305.20-305.95 3
Codes for Mental Illness The codes used to query mental illness (MI) are as follows: Any ICD-10 code between F01-F09 Any ICD-10 code between F20-F99 Any ICD-9 code between 300-302.9 Any ICD-9 code between 306-315.9 4
Substance Use Disorder SUD Total SUD Average $140,000,000.00 $1,400.00 $114,914,226.39 $114,300,424.04 $1,178.82 $1,159.46 $120,000,000.00 $1,200.00 $100,000,000.00 $1,000.00 $80,732,534.11 $832.62 $70,067,785.06 $80,000,000.00 $800.00 COST($) COST($) $706.97 $60,000,000.00 $600.00 $40,000,000.00 $400.00 $20,000,000.00 $200.00 $- $- 2023 2024 2023 2024 YEAR YEAR Allowed Paid Allowed Paid 6
SUD with Depression SUD Total SUD Average $12,103,764.01 $14,000,000.00 $900.00 $855.90 $817.44 $13,273,249.86 $800.00 $12,000,000.00 $700.00 $8,627,122.90 $8,760,503.53 $10,000,000.00 $582.64 $564.90 $600.00 $8,000,000.00 COST($) COST($) $500.00 $400.00 $6,000,000.00 $300.00 $4,000,000.00 $200.00 $2,000,000.00 $100.00 $- $- 2023 2024 2023 2024 YEAR YEAR Allowed Paid Allowed Paid 7
SUD with Anxiety SUD Total SUD Average $12,000,000.00 $1,200.00 $1,016.27 $10,087,487.76 $10,000,000.00 $1,000.00 $903.78 $8,411,438.17 $8,000,000.00 $800.00 $6,917,313.22 $6,414,461.37 $696.89 $689.21 COST($) COST($) $6,000,000.00 $600.00 $4,000,000.00 $400.00 $2,000,000.00 $200.00 $- $- 2023 2024 2023 2024 YEAR YEAR Allowed Paid Allowed Paid 8
Data Notes The trend is consistent for total SUD claims, SUD claims with depression, and SUD claims with anxiety for both total allowed and paid and average allowed and paid. There was a higher total allowed cost for SUD with depression than SUD with anxiety. 9
Mental Illness MI Total MI Average $400.00 $374.08 $365.68 $400,000,000.00 $350.00 $350,598,441.74 $350,000,000.00 $300.00 $300,000,000.00 $268,393,355.16 $233.15 $250.00 $223.36 COST($) $250,000,000.00 COST($) $209,340,246.70 $200.00 $200,000,000.00 $171,124,955.15 $150.00 $150,000,000.00 $100.00 $100,000,000.00 $50.00 $50,000,000.00 $- $- 2023 2024 2023 2024 YEAR YEAR Allowed Paid Allowed Paid 11
Mental Illness with Depression MI Total MI Average $90,000,000.00 $350.00 $80,449,042.35 $80,000,000.00 $293.72 $292.59 $300.00 $70,000,000.00 $63,770,389.68 $250.00 $60,000,000.00 $49,521,407.69 $201.31 $43,707,764.34 $200.00 $180.11 COST($) COST($) $50,000,000.00 $40,000,000.00 $150.00 $30,000,000.00 $100.00 $20,000,000.00 $50.00 $10,000,000.00 $- $- 2023 2024 2023 2024 YEAR YEAR Total Allowed Total Paid Allowed Paid 12
Mental Illness with Anxiety MI Average MI Total $600.00 $160,000,000.00 $137,924,832.59 $140,000,000.00 $477.58 $500.00 $461.76 $120,000,000.00 $103,386,971.03 $400.00 $88,458,069.44 $100,000,000.00 COST($) $306.30 COST($) $304.30 $68,132,526.79 $300.00 $80,000,000.00 $60,000,000.00 $200.00 $40,000,000.00 $100.00 $20,000,000.00 $- $- 2023 2024 2023 2024 YEAR YEAR Allowed Paid Allowed Paid 13
Data Notes There was much larger total allowed for MI with anxiety than MI with depression. The average allowed cost was much higher for MI with anxiety than MI with depression. 14
Member and Claim Counts (Total) Member Count Claim Count 200,000 1,000,000 937,224 176,848 180,000 900,000 160,000 800,000 148,758 733,965 140,000 700,000 NUMBER OF CLAIMS NUMBER OF CLAIMS 120,000 600,000 100,000 500,000 80,000 400,000 60,000 300,000 40,000 200,000 99,110 96,962 18,333 16,812 20,000 100,000 - - MI SUD MI SUD 2023 2024 2023 2024 16
Member and Claim Counts (Depression) Member Count Claim Count 70,000 300,000 274,953 62,470 60,000 250,000 51,917 217,114 50,000 NUMBER OF CLAIMS NUMBER OF CLAIMS 200,000 40,000 150,000 30,000 100,000 20,000 50,000 10,000 3,956 15,508 3,575 14,807 - - MI SUD MI SUD 2023 2024 2023 2024 17
Member and Claim Counts (Anxiety) Member Count Claim Count 100,000 350,000 86,080 90,000 288,800 300,000 80,000 70,140 250,000 70,000 NUMBER OF CLAIMS NUMBER OF CLAIMS 223,896 60,000 200,000 50,000 150,000 40,000 30,000 100,000 20,000 50,000 10,000 3,457 3,110 9,926 9,307 - - MI SUD MI SUD 2023 2024 2023 2024 18
Data Notes The total claim count and member count for MI are far greater than the SUD for total, depression, and anxiety for both years. There were more MI with anxiety total claims and members than MI with depression for both years. There are more SUD with depression total claims and members than SUD with anxiety for both years. 19
Contact Us 785-296-3071 KDOI@ks.gov insurance.kansas.gov @KSinsurancedept 1300 SW Arrowhead Road, Topeka, KS 66604
