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State Drug Utilization Data FAQs

The questions below provide answers to frequently asked questions about State Drug Utilization Data (SDUD).  If your question is not answered here, please email MDRUtilization@cms.hhs.gov, or reach out to the respective State Technical Contact.

If you have any questions regarding State Drug Utilization Data not addressed in the FAQ, please email MDRUtilization@cms.hhs.gov.

Disclaimer: Please note that the information provided on this web page does not bind or obligate the Centers for Medicare and Medicaid Services (CMS).  The statements included on this web page are intended to provide information on State Drug Utilization Data and do not in any way revise or modify the requirements set forth in Section 1927 of the Act, the national drug rebate agreement (NDRA), subsequent program releases, or regulations.

Page Last Updated on January 4, 2021

SDUD FAQs

Showing 1 to 10 of 25 results
Are 340B claims included in State Drug Utilization Data (SDUD)?

States should identify and exclude 340B claims from 340B providers before submitting their state drug utilization data to CMS.

FAQ ID:92086
Are all states required to participate in the Medicaid Drug Rebate Program (MDRP)? If not, is there a listing published by Medicaid indicating who is not participating?

Drug coverage under Medicaid is an optional benefit for the states. However, if a state opts to cover prescription drugs in their Medicaid program, they must participate in the MDRP.  As part of that participation in the MDRP, states are required to submit quarterly drug utilization data to CMS.  All states and the District of Columbia currently participate in the MDRP; therefore, they all submit quarterly drug utilization data to CMS.

FAQ ID:92061
Are drugs used in hospital outpatient settings excluded from the Medicaid Drug Rebate Program?

If a covered outpatient drug is billed as an outpatient drug and not part of a bundled service, it is rebate-eligible.

FAQ ID:92091
Does the State Drug Utilization Data (SDUD) reported for each quarter's posting always include all of the quarterly data reported by states?

If the data arrives late, it may miss the quarterly posting. However, it will be included in the next quarter's web posting.

FAQ ID:91916
Does the State Drug Utilization Data (SDUD) field "Units Reimbursed" represent the number of pills Medicaid paid for a drug that comes in a pill form?

"Units Reimbursed" are the number of units (based on Unit Type) of the drug (11-digit NDC level) reimbursed by the state or, for MCO drugs, the number of units dispensed during the Quarter/Year. For more specific information, you may contact either the Drug Manufacturer or State via the contact lists.

FAQ ID:92016
How long does a state have to report State Drug Utilization Data (SDUD) that was not previously reported?

Per section 1927 of the Act, initial submissions of quarterly state utilization data are due to CMS within 60 days of the end of each rebate period. If a state fails to report utilization data in the quarter that it was dispensed, the state must submit initial utilization data for the most recently closed quarter as well as adjustments/corrections to any previously reported utilization data.

FAQ ID:92036
How often are the State Drug Utilization Data (SDUD) and the National Summary Utilization Data updated and posted to the website?

The Centers for Medicare & Medicaid (CMS) posts updated State Drug Utilization Data (SDUD) according to the following schedule:

  • 1st Quarter (plus 5 preceding years of data): Available in August, and includes any late data reporting for 1st Quarter received from States through the end of June, plus any updates to the five preceding years of data.
  • 2nd Quarter (plus 5 preceding years of data): Available in November, and includes any late data reporting for 2nd Quarter received from States through the end of September, plus any updates to the 5  preceding years of data.
  • *3rd Quarter (update of all preceding years): Available in February, and includes any late data reporting for 3rd Quarter received from States through the end of December, plus any updates to the five preceding years of data.
  • 4th Quarter (plus 5 preceding years of data): Available in May, and includes any late data reporting for 4th Quarter received from States through the end of March, plus any updates to the five preceding years of data.

*An update of all preceding years of State Drug Utilization Data (1991 to 3rd Quarter) are posted to the website annually during the month of February. The data posted includes utilization information received from States through the end of December. The National Totals represent aggregate data by NDC-11.

See Also: With regards to State Drug Utilization Data (SDUD), is the data for each quarter's posting always comprehensive?

FAQ ID:92101
I noticed a discrepancy in the State Drug Utilization Data (SDUD), what do I do?

Should you notice apparent discrepancies in an individual state's utilization data, your questions should be directed to the State Technical Contact.

FAQ ID:92096
Is state-only utilization included in the State Drug Utilization Data (SDUD)?

State-only program utilization (e.g. ADAP) should not be included in the Federal State Medicaid Drug Rebate Program.

FAQ ID:92071
Is the amount reimbursed by Medicaid net of rebates or pre-rebate in the State Drug Utilization Data (SDUD)?

Amounts reimbursed by Medicaid are pre-rebate, not net of rebates.

FAQ ID:92001
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