CMS/EIP Fiscal Report Center: 01
Services beginning 01/01/2025 ending 03/31/2025 Date of Report:04/06/2025 Page: 1
List order: No List
Agency Filter:EXT
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 7 7.000000 339.5000 48.5000
EXIT-EXIT-COS Exit 58 65.000000 3275.0000 50.3846
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 1.500000 89.8800 59.9200
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 2 4.000000 242.9400 60.7350
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 39 71.500000 4134.4800 57.8249
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 15 27.500000 1647.8000 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 15 25.500000 2145.9700 84.1557
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 10 19.500000 1579.1100 80.9800
OCTH-97165-OT EVAL LOW COMPLEXITY 5 5.000000 290.5500 58.1100
OCTH-97165GT-OT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 3 3.000000 174.3300 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 2 2.000000 116.2200 58.1100
PSTH-97162-PT EVAL MODERATE COMPLEXITY 2 2.000000 116.2200 58.1100
SPCH-92521-EVAL OF SPEECH FLUENCY 1 8.000000 464.8800 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 2 13.000000 801.8500 61.6808
Subtotal (Total Children Is Unduplicated) 159 256.500000 15534.9500 60.5651
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 113 120.000000 5928.0000 49.4000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 84 104.000000 5212.5000 50.1202
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 39 41.750000 1075.0000 25.7485
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 94 138.500000 6925.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 123 288.000000 11400.0000 39.5833
CONIP-CONIP-CONSULT, ITDS PHONE 10 11.750000 293.7500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 12 12.000000 600.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 59 115.750000 5787.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 2 3.000000 75.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 36 41.250000 2062.5000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 35 49.000000 2450.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 2 2.000000 50.0000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 69 94.000000 4700.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 57 103.000000 5150.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 6 4.500000 137.5000 30.5556
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 1 1.000000 54.0000 54.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 526 2958.000000 159689.0000 53.9855
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 81 247.250000 13348.5000 53.9879
EPIC-99601-Early Steps Professional Development Fee 283 1600.000000 24000.0000 15.0000
INTR-T1013-INTERPRETER 86 199.250000 11324.8500 56.8374
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1271 8057.000000 96684.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 17 95.000000 7725.4000 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 2 4.000000 325.2800 81.3200
PHY-97110-PT SESSION BY LICENSED PT 47 232.250000 18793.8500 80.9208
PHY-97110GT-PT SESSION BY LICENSED PT 8 20.750000 1623.3900 78.2357
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 61 340.500000 27689.4600 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 5 29.000000 2358.2800 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 4 11.000000 716.3200 65.1200
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 1 1.000000 65.1200 65.1200
TRAV-TRAVS-Travel by mile 325 22240.00000 9903.8300 0.4453
Subtotal (Total Children Is Unduplicated) 1601 37165.50000 426229.3500 11.4684
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Total 37422.000000 441764.3000 11.8049
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Number of Children (Unduplicated) With at Least One Service 1638
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Center 01
Flag Claims Units Chgs Paid
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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 13811 33742.750000 350970.1500 350958.1500
D 344 627.000000 13104.6000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 2604 3049.250000 77527.5500 77750.7100
3 3.000000 162.0000 54.0000
Other 0 0.000000 0.0000 0.0000
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Total 16762 37422.000000 441764.3000 428762.8600