CMS/EIP Fiscal Report Statewide
Services beginning 01/01/2020 ending 03/31/2020 Date of Report:05/15/2020 Page: 1
List order: No List
Agency Filter:EIP DEI DEIP
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 13046 15164.75000 560938.5000 36.9896
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 6530 6156.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 23561 74667.00000 2761027.7500 36.9779
Subtotal (Total Children Is Unduplicated) 24864 95988.50000 3321966.2500 34.6080
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 12 15.000000 727.5000 48.5000
EVAL-96111-DEVELOPMENTAL EVALUATION 45 48.750000 2437.5000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 606 848.500000 42425.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 127 199.000000 14925.0000 75.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 3.000000 225.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 52 67.500000 5025.0000 74.4444
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 2 3.500000 262.5000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 18 29.500000 2212.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 96 164.000000 12665.3600 77.2278
IPDEF-T1024TLTSGT-F/U PHYC AND DEV EVAL BY EI PROF 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 145 241.500000 13403.2500 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 1706 2879.029866 215307.0799 74.7846
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 16 28.336800 2125.2600 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 727 1128.000000 84307.1800 74.7404
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 16 25.000000 1875.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 435 672.633333 50382.5000 74.9034
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 6 10.000000 750.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 2016 3257.500000 180494.2500 55.4088
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 19 36.000000 1887.0000 52.4167
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 763 1243.000000 96885.7300 77.9451
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 10 21.500000 1612.5000 75.0000
OCTH-97165-OT EVAL LOW COMPLEXITY 2 2.000000 102.1000 51.0500
OCTH-97166-OT EVAL MODERATE COMPLEXITY 3 3.000000 153.1500 51.0500
OCTH-97167-OT EVAL HIGH COMPLEXITY 2 2.000000 102.1000 51.0500
PSTF-97164-PT RE-EVAL EST PLAN CARE 1 1.000000 51.0500 51.0500
PSTH-97163-PT EVAL HIGH COMPLEXITY 3 4.000000 204.2000 51.0500
SCREEN-T1023-SCREENING 139 249.000000 12550.0000 50.4016
SPCH-92521-EVAL OF SPEECH FLUENCY 2 2.000000 102.1000 51.0500
SPCH-92522-EVAL OF SPCH SOUND PROD 1 1.000000 51.0500 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 46 46.000000 2348.3000 51.0500
SPCH-92524-BEHAV & QUAL ANALYSIS OF VOICE AND RES 1 1.000000 51.0500 51.0500
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 2 2.000000 97.8800 48.9400
Subtotal (Total Children Is Unduplicated) 4344 11238.25000 746009.0899 66.3813
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 278 308.500000 15400.0000 49.9190
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 19 33.500000 1675.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 39 35.250000 881.2500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 809 728.750000 36437.5000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 90 71.000000 3550.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 64 51.750000 1293.7500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 564 329.750000 16487.5000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 21 12.500000 625.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 33 19.000000 468.7500 24.6711
CONPF-CONPF-CONSULT, PT, FACE TO FACE 353 227.750000 11387.5000 50.0000
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 21 11.500000 575.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 32 10.250000 256.2500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 436 370.000000 18462.5000 49.8986
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 32 22.000000 1100.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 55 36.250000 906.2500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 1795 4180.000000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 26 58.000000 1450.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 792 3570.750000 178477.5000 49.9832
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 187 244.500000 12225.0000 50.0000
INTR-T1013-INTERPRETER 311 540.750000 27037.5000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1336 5266.000000 52660.0000 10.0000
OCCT-97530-OT SESSION BY LICENSED OT 210 1015.000000 72443.9200 71.3733
OCCT-97530GT-OT SESSION BY LICENSED OT 73 101.000000 7204.7600 71.3343
OCCT-97530HM-OT SESSION BY OT ASST 1 1.000000 57.2000 57.2000
OCCT-97530HMGT-OT SESSION BY OT ASST 3 4.000000 228.8000 57.2000
OCCT-97530TL-OT SESSION BY LICENSED OT 3 3.000000 214.3200 71.4400
OCCT-97530TLGT-OT SESSION BY LICENSED OT 3 3.000000 214.3200 71.4400
PHY-97110-PT SESSION BY LICENSED PT 192 914.250000 65314.0200 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 65 94.500000 6736.8000 71.2889
PHY-97110HM-PT SESSION BY PT ASST 1 1.000000 57.1600 57.1600
PHY-97110TLGT-PT SESSION BY LICENSED PT 3 4.000000 285.7600 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 351 1671.750000 119032.1400 71.2021
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 99 127.250000 9076.4600 71.3278
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 1 1.000000 57.2000 57.2000
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 4 19.000000 1357.3600 71.4400
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 1 0.500000 35.7200 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 7 6.000000 83.2800 13.8800
CMS/EIP Fiscal Report Statewide
Services beginning 01/01/2020 ending 03/31/2020 Date of Report:05/15/2020 Page: 2
List order: No List
Agency Filter:EIP DEI DEIP
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 151 112.250000 4153.2500 37.0000
TRAV-TRAVS-Travel by mile 470 32630.00000 14517.6300 0.4449
Subtotal (Total Children Is Unduplicated) 3249 52836.25000 682426.3500 12.9159
-----------------------------------------------------------------------------------------------------------------------
Total 160062.999999 4750401.6899 29.6783
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 25181
-----------------------------------------------------------------------------------------------------------------------
Center 01
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 2 1.750000 64.7500 64.7500
D 8 7.750000 521.1400 0.0000
S 5 4.000000 208.4400 0.0000
H 11031 7631.250000 332591.9300 297861.9900
T 0 0.000000 0.0000 0.0000
8047 5119.500000 178310.2200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 19093 12764.250000 511696.4800 297926.7400
Center 02
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
0 0.000000 0.0000 0.0000
Other 5343 14646.000000 107632.8300 0.0000
---------------------------------------------------------
Total 5343 14646.000000 107632.8300 0.0000
Center 03
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 232 130.000000 4837.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 3006 2062.000000 85823.7500 0.0000
P 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 1 1.000000 50.0000 50.0000
T 0 0.000000 0.0000 0.0000
5412 5563.750000 129543.3500 0.0000
Other 46 26.000000 962.0000 0.0000
---------------------------------------------------------
Total 8697 7782.750000 221216.8500 50.0000
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 34 49.750000 1840.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 1103 1594.000000 61738.7500 101.7500
P 2568 3931.250000 156988.8800 156521.9200
D 2 2.000000 130.5000 0.0000
S 2 4.000000 148.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
4115 3898.250000 157952.5100 81.4600
Other 4 6.000000 222.0000 0.0000
---------------------------------------------------------
Total 7828 9485.250000 379021.3900 156705.1300
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 21 14.750000 685.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 3081 2004.750000 77350.2000 52811.3700
P 40 168.000000 3500.2200 3500.2200
D 40 23.250000 898.2500 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
3247 1878.000000 56090.5000 812.5000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 6429 4088.750000 138524.9200 57124.0900
Center 06
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 1 0.750000 27.7500 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
12415 7892.750000 313316.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 12416 7893.500000 313343.7500 0.0000
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 26 127.000000 6129.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 957 703.500000 27455.0000 0.0000
P 3292 2710.837400 113806.8050 114451.2300
D 61 59.000000 3337.0500 0.0000
S 3 2.250000 96.2500 0.0000
H 25 49.000000 3651.0500 0.0000
T 0 0.000000 0.0000 0.0000
7829 4384.412600 131718.0450 0.0000
Other 1 0.250000 9.2500 0.0000
---------------------------------------------------------
Total 12194 8036.250000 286202.4500 114451.2300
Center 09
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 1 2.000000 150.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 176 171.250000 6781.2500 0.0000
P 15765 14357.000000 537682.2800 537731.5400
D 58 53.500000 2186.1400 0.0000
S 0 0.000000 0.0000 0.0000
H 343 512.500000 25462.0000 0.0000
T 0 0.000000 0.0000 0.0000
15 15.500000 1116.2200 0.0000
Other 2 2.500000 162.5000 0.0000
---------------------------------------------------------
Total 16360 15114.250000 573540.3900 537731.5400
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 138 106.250000 4413.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1049 776.500000 30820.2500 9.2500
P 8545 6697.000000 277273.5000 287617.1000
D 37 37.250000 1839.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
6487 5353.750000 201076.2500 0.0000
Other 59 114.000000 7750.5000 0.0000
---------------------------------------------------------
Total 16315 13084.750000 523172.5000 287626.3500
Center 51
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1062 783.250000 32870.3300 0.0000
P 364 292.000000 11422.5000 11273.7500
D 14 12.500000 538.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
2811 2034.500000 71136.5900 0.0000
Other 1 1.000000 71.4400 0.0000
---------------------------------------------------------
Total 4252 3123.250000 116038.8600 11273.7500
Center 52
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 5 3.250000 120.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 317 289.250000 14158.4100 0.0000
P 1347 1354.500000 63155.4200 62187.8800
D 4 4.000000 200.0000 200.0000
S 523 501.250000 19124.2500 355.7500
H 145 188.500000 12558.1600 447.7600
T 2078 19988.000000 58951.6200 48006.9500
1883 1576.250000 45465.2500 55.6800
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 6302 23905.000000 213733.3600 111254.0200
Center 53
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 6 4.250000 170.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 909 787.750000 34949.6500 1009.6900
P 3038 2644.000000 121896.5500 121778.2200
D 356 340.250000 21204.8700 71.4400
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 3 2.500000 149.5000 0.0000
10632 7753.250000 175635.7500 150.0000
Other 98 103.500000 6870.7400 0.0000
---------------------------------------------------------
Total 15042 11635.500000 360877.3100 123009.3500
Center 54
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1252 1032.750000 48565.8000 157.2500
P 4811 3684.355924 161055.9400 167135.3200
D 346 315.144076 20655.3200 3.3000
S 0 0.000000 0.0000 0.0000
H 4 3.250000 126.7500 34.2500
T 9 8.500000 405.9400 0.0000
11689 8068.750000 179243.5200 0.0000
Other 105 103.000000 6770.7300 0.0000
---------------------------------------------------------
Total 18216 13215.750000 416824.0000 167330.1200
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1096 852.250000 34522.7800 129.5000
P 3345 2423.000000 96158.4900 112554.7900
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 8 14.000000 1042.8800 0.0000
T 0 0.000000 0.0000 0.0000
5390 3055.249999 112491.4699 0.0000
Other 4 4.000000 244.9800 0.0000
---------------------------------------------------------
Total 9843 6348.499999 244460.5999 112684.2900
Center 57
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 341 339.750000 14367.2500 18.5000
P 4394 4517.000000 177404.5000 175257.7220
D 14 7.000000 259.0000 0.0000
S 1 3.000000 111.0000 111.0000
H 16 15.750000 611.5000 75.0000
T 0 0.000000 0.0000 0.0000
4561 4056.000000 151335.0000 0.0000
Other 1 0.750000 27.7500 27.7500
---------------------------------------------------------
Total 9328 8939.250000 344116.0000 175489.9720