CMS/EIP Fiscal Report Statewide
Services beginning 07/01/2019 ending 06/30/2020 Date of Report:07/21/2020 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 29845 59322.50000 2194204.5000 36.9877
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 17548 20522.75000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 43689 291472.2500 10779144.2500 36.9817
Subtotal (Total Children Is Unduplicated) 45113 371317.5000 12973348.7500 34.9387
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 45 56.000000 2716.0000 48.5000
EVAL-96111-DEVELOPMENTAL EVALUATION 268 309.250000 15462.5000 50.0000
EVAL-96111GT-DEVELOPMENTAL EVALUATION 5 7.000000 350.0000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 1985 2809.250000 140450.0000 49.9956
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 423 662.500000 49552.5000 74.7962
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 66 102.000000 7650.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 164 231.500000 17167.5000 74.1577
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 41 59.000000 4425.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 71 114.000000 8480.5000 74.3904
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 21 34.000000 2550.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 315 550.500000 43442.3600 78.9144
IPDEF-T1024TLTSGT-F/U PHYC AND DEV EVAL BY EI PROF 44 77.000000 5775.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 481 752.000000 41655.0000 55.3923
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 88 158.500000 8796.7500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 5642 9444.892932 702749.9399 74.4053
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 1123 2007.166667 150064.5000 74.7643
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 2310 3582.163200 265655.2600 74.1606
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 443 726.000000 54400.0000 74.9311
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 1644 2531.633333 189216.9900 74.7411
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 378 646.000000 48361.0000 74.8622
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 6984 11164.50000 618433.8800 55.3929
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 1330 2343.000000 129555.5200 55.2947
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 2822 4649.482634 364124.6175 78.3151
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 556 1030.000000 77250.0000 75.0000
MED-99203-OUTPATIENT VISIT, NEW, 30 MINS 34 34.000000 3963.6600 116.5782
MED-99204-OUTPATIENT VISIT, NEW, 45 MINS 5 5.000000 1263.8700 252.7740
MED-99213-OUTPATIENT VISIT, EST, 15 MINS 6 6.000000 140.5200 23.4200
MED-99214-OUTPATIENT VISIT, EST, 25 MINS 1 1.000000 36.4900 36.4900
OCTH-97165-OT EVAL LOW COMPLEXITY 5 5.000000 255.2500 51.0500
OCTH-97166-OT EVAL MODERATE COMPLEXITY 11 11.000000 561.5500 51.0500
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 51.0500 51.0500
OCTH-97166TLGT-OT EVAL MODERATE COMPLEXITY 5 5.000000 255.2500 51.0500
OCTH-97167-OT EVAL HIGH COMPLEXITY 14 14.000000 714.7000 51.0500
OCTH-97167TLGT-OT EVAL HIGH COMPLEXITY 1 1.000000 51.0500 51.0500
PSTF-97164-PT RE-EVAL EST PLAN CARE 1 1.000000 51.0500 51.0500
PSTH-97161-PT EVAL LOW COMPLEXITY 3 3.000000 153.1500 51.0500
PSTH-97161GT-PT EVAL LOW COMPLEXITY 1 1.000000 51.0500 51.0500
PSTH-97162-PT EVAL MODERATE COMPLEXITY 5 5.000000 255.2500 51.0500
PSTH-97162GT-PT EVAL MODERATE COMPLEXITY 1 1.000000 51.0500 51.0500
PSTH-97163-PT EVAL HIGH COMPLEXITY 7 9.000000 459.4500 51.0500
PSTH-97163GT-PT EVAL HIGH COMPLEXITY 2 2.000000 102.1000 51.0500
SCREEN-T1023-SCREENING 467 622.000000 31300.0000 50.3215
SPCH-92521-EVAL OF SPEECH FLUENCY 4 4.000000 204.2000 51.0500
SPCH-92522-EVAL OF SPCH SOUND PROD 2 2.000000 102.1000 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 112 120.000000 6111.0000 50.9250
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 7 7.000000 357.3500 51.0500
SPCH-92523TL-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 4 4.000000 204.2000 51.0500
SPCH-92523TLGT-EVAL OF SPCH SOUND PROD; EVAL LANG COM 6 6.000000 306.3000 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 3 3.000000 146.8200 48.9400
SPCH-92610GT-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 44.5500 44.5500
Subtotal (Total Children Is Unduplicated) 16837 44922.33877 2995528.8774 66.6824
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 810 1054.000000 52646.4400 49.9492
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 258 315.250000 15762.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 190 177.500000 4437.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 1821 2237.500000 111762.5000 49.9497
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 884 899.750000 44975.0000 49.9861
CONIP-CONIP-CONSULT, ITDS PHONE 157 143.750000 3593.7500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1309 1068.250000 53400.0000 49.9883
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 654 433.250000 21662.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 124 67.750000 1687.5000 24.9077
CONPF-CONPF-CONSULT, PT, FACE TO FACE 967 879.000000 43937.5000 49.9858
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 384 258.000000 12900.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 106 47.500000 1181.2500 24.8684
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 1249 1447.750000 72300.0000 49.9396
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 646 621.750000 31075.0000 49.9799
CONSP-CONSP-CONSULT, SLP, PHONE 155 131.750000 3293.7500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 3982 14249.50000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 47 134.000000 3350.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1479 12831.25000 641472.5000 49.9930
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 532 2826.500000 141325.0000 50.0000
CMS/EIP Fiscal Report Statewide
Services beginning 07/01/2019 ending 06/30/2020 Date of Report:07/21/2020 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
INTR-T1013-INTERPRETER 790 1747.000000 87267.7500 49.9529
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 2921 22177.00000 221720.0000 9.9977
OCCT-97530-OT SESSION BY LICENSED OT 327 3168.748600 226208.3760 71.3873
OCCT-97530GT-OT SESSION BY LICENSED OT 161 755.750000 54015.8200 71.4731
OCCT-97530HM-OT SESSION BY OT ASST 8 16.750000 958.1000 57.2000
OCCT-97530HMGT-OT SESSION BY OT ASST 2 3.000000 171.6000 57.2000
OCCT-97530TL-OT SESSION BY LICENSED OT 11 17.000000 1214.4800 71.4400
OCCT-97530TLGT-OT SESSION BY LICENSED OT 93 372.500000 26611.4000 71.4400
PHY-97110-PT SESSION BY LICENSED PT 312 3276.710002 233899.7600 71.3825
PHY-97110GT-PT SESSION BY LICENSED PT 130 683.840000 48890.0800 71.4934
PHY-97110HM-PT SESSION BY PT ASST 11 39.000000 2229.2400 57.1600
PHY-97110TL-PT SESSION BY LICENSED PT 11 19.250000 1375.2200 71.4400
PHY-97110TLGT-PT SESSION BY LICENSED PT 70 301.000000 21442.6000 71.2379
SENS-HA_INS-SENSORY AID INSURANCE PER EAR 1 1.000000 525.0000 525.0000
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 612 5792.300006 404831.2660 69.8913
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 273 1334.750000 94960.6800 71.1449
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 1 1.000000 57.2000 57.2000
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 41 155.000000 11073.2000 71.4400
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 120 443.000000 31647.9200 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 24 67.000000 929.9600 13.8800
SPL-92508TLGT-SPL THERAPY SESSION BY LICENSED SLP 8 9.500000 131.8600 13.8800
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 320 546.000000 20202.0000 37.0000
TRAV-TRAVS-Travel by mile 1208 107939.0000 48022.9900 0.4449
Subtotal (Total Children Is Unduplicated) 7243 188690.0986 2799149.1920 14.8346
-----------------------------------------------------------------------------------------------------------------------
Total 604929.937374 18768026.8194 31.0251
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 45349
-----------------------------------------------------------------------------------------------------------------------
Center 01
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1 0.750000 27.7500 0.0000
P 8039 5433.500000 212453.2000 212376.9500
D 56 44.500000 2288.8500 0.0000
S 4452 2999.750000 127145.7000 0.0000
H 29593 21467.750000 972791.6000 853491.9200
T 0 0.000000 0.0000 0.0000
28697 18544.250000 676693.8500 0.0000
Other 4 6.750000 382.7500 83.2500
---------------------------------------------------------
Total 70842 48497.250000 1991783.7000 1065952.1200
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 21753 51565.250000 452424.4400 0.0000
---------------------------------------------------------
Total 21753 51565.250000 452424.4400 0.0000
Center 03
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 193 151.750000 6177.2100 0.0000
U 0 0.000000 0.0000 0.0000
B 13566 9289.000000 381769.7800 0.0000
P 4 2.750000 87.7500 87.7500
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
21359 16733.750000 511751.0200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 35122 26177.250000 899785.7600 87.7500
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 330 497.000000 18389.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 4812 7000.500000 264047.5000 0.0000
P 11695 17276.750000 693110.0500 686932.3700
D 39 53.750000 2121.2500 0.0000
S 4 6.500000 240.5000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
15544 14007.500000 579996.6900 0.0000
Other 4 5.500000 203.5000 0.0000
---------------------------------------------------------
Total 32428 38847.500000 1558108.4900 686932.3700
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 28 32.250000 1980.5700 0.0000
U 0 0.000000 0.0000 0.0000
B 11391 7476.000000 287238.8400 239822.8000
P 286 1370.000000 21022.1800 21022.1800
D 239 171.250000 6715.9600 0.0000
S 0 0.000000 0.0000 0.0000
H 1 0.500000 25.0000 25.0000
T 0 0.000000 0.0000 0.0000
11430 6678.500000 205576.4500 205.9500
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 23375 15728.500000 522559.0000 261075.9300
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 3 3.000000 111.0000 111.0000
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
48446 30714.250000 1219794.7200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 48450 30718.000000 1219933.4700 111.0000
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 122 105.250000 4646.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 2221 1673.250000 66719.9500 0.0000
P 13150 11119.261100 466708.8350 469150.1000
D 476 434.750000 23082.8000 0.0000
S 4 3.500000 142.5000 0.0000
H 46 91.000000 6725.0500 0.0000
T 0 0.000000 0.0000 0.0000
29600 16579.747800 528242.0325 0.0000
Other 1 2.000000 111.0000 0.0000
---------------------------------------------------------
Total 45620 30008.758900 1096378.4175 469150.1000
Center 09
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 41 52.000000 2202.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 780 810.750000 31496.0000 0.0000
P 57415 52894.500000 1995332.8600 1996478.2400
D 145 136.000000 5874.6400 0.0000
S 0 0.000000 0.0000 0.0000
H 935 1394.500000 70325.2500 0.0000
T 4 18.500000 684.5000 573.5000
3738 3269.500000 126578.4100 9.2500
Other 2 2.500000 162.5000 0.0000
---------------------------------------------------------
Total 63060 58578.250000 2232656.1600 1997060.9900
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 463 351.750000 13336.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 4025 2988.750000 120994.5000 83.2500
P 35020 27196.500000 1126193.0000 1134467.3030
D 232 183.250000 7694.0000 0.0000
S 90 165.000000 11361.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
24309 19768.250000 737725.2500 0.0000
Other 467 829.750000 56383.0000 0.0000
---------------------------------------------------------
Total 64606 51483.250000 2073687.5000 1134550.5530
Center 51
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 15 8.000000 296.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 4180 3074.750000 124872.0800 0.0000
P 2158 1614.750000 63825.7500 63623.7500
D 73 52.000000 2309.4600 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
10202 7153.250000 247025.1400 0.0000
Other 2 2.000000 126.9400 0.0000
---------------------------------------------------------
Total 16630 11904.750000 438455.3700 63623.7500
Center 52
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 3 6.000000 450.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1620 1616.500000 72702.0900 25.0000
P 6451 6369.000000 302980.7400 292235.6200
D 9 10.000000 533.4900 462.0500
S 1067 1069.250000 40064.0900 564.2000
H 213 256.500000 17354.1600 460.4200
T 7143 69008.250000 218503.3500 175834.7400
7655 5702.500000 185688.2000 265.5900
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 24161 84038.000000 838276.1200 469847.6200
Center 53
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 31 21.500000 1187.3400 0.0000
U 0 0.000000 0.0000 0.0000
B 3477 2972.000000 142644.1500 149.1900
P 11759 10686.400000 496698.1700 499505.2800
D 1541 1497.940000 86085.4860 0.0000
S 13 12.250000 689.2100 0.0000
H 43 42.500000 2827.1600 50.0000
T 9 17.500000 451.9500 4.4500
41349 30562.010000 688149.0600 37.0000
Other 550 557.750000 37573.0100 0.0000
---------------------------------------------------------
Total 58772 46369.850000 1456305.5360 499745.9200
Center 54
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 18 15.500000 1047.0500 0.0000
U 0 0.000000 0.0000 0.0000
B 3228 2632.750000 123068.5500 157.2500
P 18724 15075.522900 675252.8860 677407.3700
D 1423 1319.375708 88437.5000 95.8000
S 2 2.000000 10.0000 0.0000
H 51 52.220000 3531.0100 0.0000
T 21 18.500000 782.6300 0.0000
47860 33827.380000 818576.6200 112.0800
Other 482 468.000000 31738.1300 133.2500
---------------------------------------------------------
Total 71809 53411.248608 1742444.3760 677905.7500
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 7 7.250000 240.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 3364 2656.583333 113479.7900 216.5000
P 13465 10318.166667 415431.9400 429520.5600
D 0 0.000000 0.0000 0.0000
S 1 1.333333 100.0000 0.0000
H 50 74.250000 5141.1200 0.0000
T 0 0.000000 0.0000 0.0000
19678 11653.159733 430853.4899 0.0000
Other 3 2.836800 205.6400 0.0000
---------------------------------------------------------
Total 36568 24713.579866 965452.4799 429737.0600
Center 57
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 1 0.250000 9.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 1232 1388.750000 55176.0000 157.2500
P 15891 17073.750000 676612.5000 670328.7200
D 13 10.000000 370.0000 314.5000
S 1 3.000000 111.0000 111.0000
H 19 26.250000 1047.2500 27.7500
T 0 0.000000 0.0000 0.0000
16081 14385.750000 546422.2500 0.0000
Other 1 0.750000 27.7500 27.7500
---------------------------------------------------------
Total 33239 32888.500000 1279776.0000 670966.9700