CMS/EIP Fiscal Report Center: 06
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
AUDE-92557-COMP AUDIO THRESHOLD EVAL/SPCH RECOG 1 1.000000 24.2800 24.2800
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 1 1.000000 7.9200 7.9200
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 1 1.000000 31.8100 31.8100
EXIT-EXIT-COS Exit 64 64.000000 3200.0000 50.0000
Subtotal (Total Children Is Unduplicated) 66 67.000000 3264.0100 48.7166
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 48 47.250000 2352.0000 49.7778
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 59 61.250000 3025.0000 49.3878
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 36 37.500000 900.0000 24.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 1 1.000000 50.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 5 4.000000 200.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 0.500000 12.5000 25.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 5 5.000000 250.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 2 1.750000 62.5000 35.7143
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 2 3.000000 150.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 809 5388.750000 295111.5000 54.7644
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 178 835.250000 44995.5000 53.8707
EPIC-99601-Early Steps Professional Development Fee 465 3126.000000 46557.0000 14.8935
INTR-T1013-INTERPRETER 42 296.000000 20400.0000 68.9189
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 408 2607.000000 31047.0000 11.9091
OCCT-97530-OT SESSION BY LICENSED OT 4 13.500000 772.5400 57.2252
OCCT-97530GT-OT SESSION BY LICENSED OT 6 23.500000 1858.0800 79.0672
OCCT-97530HM-OT SESSION BY OT ASST 2 6.500000 423.2800 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 1 1.500000 97.6800 65.1200
PHY-97110-PT SESSION BY LICENSED PT 18 123.750000 10023.3500 80.9968
PHY-97110GT-PT SESSION BY LICENSED PT 5 12.000000 970.0600 80.8383
PHY-97110HM-PT SESSION BY PT ASST 8 48.000000 2944.3600 61.3408
PHY-97110HMGT-PT SESSION BY PT ASST 4 16.000000 976.8000 61.0500
SENS-V5264-EARMOLD 1 2.000000 36.2600 18.1300
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 28 145.250000 11811.7300 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 17 73.500000 5977.0200 81.3200
Subtotal (Total Children Is Unduplicated) 996 12879.75000 481004.1600 37.3458
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Total 12946.750000 484268.1700 37.4046
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Number of Children (Unduplicated) With at Least One Service 1000
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Center 06
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 4060 4141.000000 121521.4700 121521.4700
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
8734 8805.750000 362746.7000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 12794 12946.750000 484268.1700 121521.4700