diagnoses would likely result in conservative estimates of treatment costs and utilization for the sample. Second, it is unclear whether diagnoses made in childhood would persist as the child ages into adulthood, although some suggest that bipolar I and bipolar II may be continuous from childhood to adulthood.(41) These factors may impact the long term costs of treatment, but would not impact the short-term estimates provided in this study. Third, total costs are based on actual payments received by physicians from both the health plan and the patient. These costs are based on negotiated prices between the health plan and the provider and may not be generalizable to publicly insured or to uninsured populations. Finally, cost estimates generated for patient out-of-pocket payments must be interpreted with caution as details on the cost-sharing arrangements between health plans and patients (such as the plan premium) were not available for this analysis.
