2025 State Report Cards Methodology & Measures

2025 Maternal Mental Health State Report Cards

Methodology and Measures

Overview 

The 2025 Maternal Mental Health (MMH) state report cards include 20 measures across 3 domains:

1. Providers and Programs 
2. Screening: Results, Requirements, and Reimbursement
3. Insurance Coverage and Treatment Reimbursement

What changed in 2024? 

Measures

Measures remain the same as the 2024 measures, with the addition of two new measures. Both measures were added to the “Insurance Coverage and Treatment Reimbursement” domain:

• State provides enhanced Medicaid reimbursement or state investment in group prenatal care (1 point)
• Medicaid coverage of group parenting programs (2 points)

Please note: States were awarded points if they met these new measures. However, states were not penalized if they did not meet these new measures, and their grades did not drop. This is because the overall point/grading system has stayed the same ( A = 38+ points; B+ = 35-37 points; B = 29-4; etc).

Measure Data Sources

In 2025, the data source for measures #10 and #11 changed. The data source for these measures in 2024 was NASHP’s State Use of Behavioral Health Performance Measures in Medicaid Managed Care report. In 2025, the Policy Center for MMH conducted an updated scan of Medicaid managed care performance measures and published the results in the following report: The Role of Medicaid in Advancing Obstetric Provider Maternal Mental Health Screening and Treatment. This report is the updated data source for measures #10 and #11 in 2025.  The 2024 MMH state report card measures can be found here.

Measure Points:

There were no changes to the points provided in any measure this year.

2025 Measures by Domain

Domain 1: Providers and Programs

1. Meets ratio of non-prescriber MMH providers to perinatal population (5 per 1,000 births) 

• Item: The state has at least 5 non-prescriber MMH providers for every 1,000 births. (Providers include Perinatal Mental Health Certified (PMH-C) providers and university health system maternal mental health program providers.)  
• Datasets: PSI PMH-C Directory and Marce of North America’s list of Reproductive Mental Health Academic Programs 
• Scoring: 3 points for states that meet the ratio

2. Meets ratio of MMH prescribers to perinatal population (1 per 5,000 births) 

• Item: The state has at least one mental health prescriber with specialized perinatal training for every 5,000 births. This includes MDs and other psychiatric providers who have received training as reproductive psychiatrists. This measure excludes other MDs, such as OB/Gyns, though it is recommended that OB/Gyns and other maternity care providers prescribe medications according to clinical guidelines.  
• Dataset: PSI Prescriber Directory and Marce of North America’s list of Reproductive Mental Health Academic Programs  
• Scoring: 3 points for states that meet the ratio

3. Has at least one inpatient or residential MMH treatment program 

• Item: The state has MMH inpatient program(s) or residential program(s). This excludes residential treatment programs providing only Substance Use Disorder treatment, such as “Pregnant and Postpartum Women” programs.
• Dataset: Postpartum Support International list of inpatient programs 
• Scoring: 1 point per program, capped at 3 points per state

4. Has at least one MMH intensive outpatient program (IOP) or partial hospitalization program (PHP)

• Item: The state has an outpatient MMH program(s)
• Dataset: Postpartum Support International list of outpatient programs 
• Scoring: 1 point per program, capped at 3 points per state

5. Has or has had a state-sanctioned MMH Task Force or Commission

• Item: State has or had formed a MMH Task Force or Commission to issue a strategic plan 
• Dataset: 2025 MMH Task Force Tracker
• Scoring: 3 points if state has a Task Force or Commission

6. Meets ratio of community-based organizations (CBOs) providing direct service for MMH (at least 1 per 50,000 births) 

• Item: State has at least 1 CBO providing MMH services per 50,000 births
• Dataset: Policy Center for Maternal Mental Health’s Nonprofit map list
• Scoring: If state meets ratio of 1 CBO per 50,000 births, state receives 1 point per CBO, capped at 3 points per state.
• Note: This measure remains preliminary, with low reliability. Additional CBOs can be submitted to the Policy Center for Maternal Mental Health’s Nonprofit map.

7. State Perinatal State Perinatal Quality Collaborative (PQC) has prioritized MMH

• Item: State PQC has named MMH as a priority 
• Dataset: The National Network of Perinatal Quality Collaboratives list of PQCs prioritizing MMH
• Scoring: If state PQC has made MMH a priority, state receives 1 point

Domain 2: Screening Results, Requirements and Reimbursement  

8. Top performer on the HEDIS “prenatal depression screening” measure (among commercial insurance and/or Medicaid)

• Item: State HEDIS prenatal depression screening measure scores are >=10%
• Dataset: HEDIS State Reporting dataset for RY 2024/MY 2023 
• Scoring: 4 points if HEDIS measure scores are >=10%.

9.Top performer on the HEDIS “postpartum depression screening” measure (among commercial insurance and/or Medicaid)

• Item: State HEDIS postpartum depression screening measure scores are >=10%
• Dataset: HEDIS State Reporting dataset for RY 2024/MY 2023
• Scoring: 4 points if HEDIS measure scores are >=10%.

10. State Medicaid requires MCOs to report “prenatal depression screening” HEDIS measure 

• Item: State Medicaid agency requires reporting of HEDIS PND-E measure
• Dataset: 2024 Policy Center for MMH analysis of State Medicaid HEDIS requirements, found in The Role of Medicaid in Advancing Obstetric Provider Maternal Mental Health Screening and Treatment
• Scoring: 2 points if measure collected, 3 points if Medicaid provides MCOs an incentive payment for performance on this

11. Medicaid requires MCOs to report and/or incentivizes performance for “postpartum depression screening” HEDIS measure

• Item: State Medicaid agency requires reporting of HEDIS PDS-E measure
• Dataset: 2024 Policy Center for MMH analysis of State Medicaid HEDIS requirements, found in The Role of Medicaid in Advancing Obstetric Provider Maternal Mental Health Screening and Treatment
• Scoring: 2 points if measure collected, 3 points if Medicaid provides MCOs  an incentive payment for performance on this measure

12. Maternity providers submit claims to private insurers for prenatal MMH screening (among at least 1% of prenatal patients)

• Item: % persons who are privately insured and pregnant whose provider billed for mental health screening. Note: Providers include nurse practitioners, physician assistants, OB/Gyns, family practice providers, and midwives.
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database; 2022 claims data. Note: This data was not refreshed in 2025. Procedure codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for prenatal MMH screening: 1-3% = 0.5 points, 3%-14% = 1 point, 15% or higher = 3 points. States with reported OB screening > 1% receive 1 extra point. 
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

13. Maternity providers submit claims to private insurers for postpartum MMH screening (among at least 1% of postpartum patients)

• Item: % persons who are privately insured and in the postpartum period whose provider billed for mental health screening Note: Providers include nurse practitioners, physician assistants, OB/Gyns, family practice providers, and midwives.
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database; 2022 claims data. Note: This data was not refreshed in 2025. Procedures codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for postpartum MMH screening: 1-3% = 0.5 points, 3%-14% = 1 point, 15% or higher = 3 points. 
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

Domain 3: Insurance Coverage and Treatment Payment

14. Expanded Medicaid 

• Item: The state has adopted Medicaid expansion
• Dataset: Kaiser Family Foundation Medicaid Expansion Tracker
• Scoring: 1 point if the state had expanded Medicaid 

15. Extended Medicaid coverage to one year postpartum  

• Item: State implemented or is planning to implement postpartum coverage for Medicaid beneficiaries to 12 months postpartum
• Dataset: Kaiser Family Foundation Postpartum Medicaid Extension Tracker
• Scoring: 2 points if the state has extended Medicaid coverage to one year postpartum

16. Requires health plans to develop an MMH quality management program

• Item: The state mandates that commercial and Medicaid health plans/insurers develop a maternal mental health quality management program 
• Dataset: Mandated MMH Quality Management Program Tracker
• Scoring: 3 points if the state mandates health plans/insurers have a MMH quality management program

17. Providers submit claims to private insurers for prenatal MMH treatment

• Item: % persons who are privately insured and pregnant whose provider billed for mental health treatment. Providers include psychiatrists, psychiatric nurses, psychologists, behavioral health providers, registered nurses, nurse practitioners, physician assistants, OB/Gyns, midwives, and family practice. 
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database; 2022 claims data. Note: This data was not refreshed in 2025. Procedure codes included in the dataset can be found here. 
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for prenatal mental health treatment: 10%-14% = 1 point, 15% or higher = 3 points
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

18. Providers submit claims to private insurers for postpartum MMH treatment

• Item: % persons who are privately insured in the postpartum period whose provider billed for mental health treatment (any provider) 
• Dataset: Analysis of FAIR Health NPIC® (National Private Insurance Claims) Database; 2022 claims data. Note: This data was not refreshed in 2025. Procedures codes included in the dataset can be found here.
• Scoring: Points provided based on the percentage of patients whose provider bills private insurance for postpartum mental health treatment: 10%-14% = 1 point, 15% or higher = 3 points)
• Note: For this measure, providers include psychiatrists, psychiatric nurses, psychologists, behavioral health providers, registered nurses, nurse practitioners, physician assistants, OB/Gyns, midwives, and family practice. (Note: “MMH treatment” among non-behavioral health providers is provided through evaluation & management.) 
• Disclaimer: FAIR Health, Inc. is not responsible for the research or opinions expressed in this publication.

19. State provides enhanced Medicaid reimbursement or state investment in group prenatal care (New in 2025)

• Item: State provides enhanced Medicaid reimbursement or invests funding in group prenatal care
• Dataset: 2023 Prenatal To 3 Policy State Policy Roadmap
• Scoring: State receives 1 point if the state provides enhanced reimbursement; 1 point if state reimburses through the Medicaid program or funds group prenatal care in another manner; 2 points if state provides both

20. Medicaid coverage of group parenting programs (New in 2025)

• Item: Medicaid coverage of group parenting programs (without requiring the child have a diagnosis)
• Dataset: 2023 Infant-Early Childhood Mental Health (IECMH) Medicaid Survey
• Scoring: 2 points for each state that meets this measure

For more information regarding data or methodology, please email [email protected].