Health Conditions, Utilization, and Expenditures of Children in Foster Care. Medicaid Expenditures


The analysis of Medicaid expenditures is based on data reported in the SMRF person summary file, which aggregates annual amounts paid by Medicaid within 24 types of service (TOS) categories.(8) These categories were further aggregated into four service groups to create subtotals of analytic interest. The TOS classification is shown in Table II.4. For most analyses, we compare average (mean) monthly expenditures across groups, which were derived by dividing total expenditures for the year by the number of months of enrollment. As we will discuss in the next chapter, there are some inconsistencies in how states classify claims by type of service. Most notable for the purpose of this study is state variation in the classification of mental health services.

Table II.4:
SMRF Type of Service Classification for Analysis of Medicaid Expenditures.
Service Group SMRF Type of
Service Code
SMRF Type of Service Category
Institutional Services 01 Inpatient hospital
  04 Inpatient psychiatric services for children
  05 Intermediate care facility for the mentally retarded (ICF-MR)
  07 All other nursing facilities
Outpatient Services 08 Physicians
  09 Dental(a)
  10 Other practitioners
  11 Outpatient hospital
  12 Clinic
  14 Family planning services
  17 Early and periodic screening, diagnosis, and treatment (EPSDT)
  18 Rural health clinic services
Anciliary Services 13 Home health services
  15 Lab and x-ray services
  16 Prescribed drugs
  21 Equipment and supplies
  22 Transportation
  23 Case management services
  19, 22 Other services, unknown
a. For California, this category includes premiums paid for prepaid dental coverage.