CMS/EIP Fiscal Report Center: 52
Services beginning 01/01/2025 ending 03/31/2025 Date of Report:04/06/2025 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 474 265.750000 9858.2500 37.0960
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 21 12.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 728 2156.750000 79691.7000 36.9499
Subtotal (Total Children Is Unduplicated) 828 2434.500000 89549.9500 36.7837
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 5 10.000000 809.8000 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 11 22.000000 1318.2400 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 28 55.000000 4453.9000 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 7 14.000000 1133.7200 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 18 36.000000 2834.3000 78.7306
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 31 61.000000 4939.7800 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 108 215.000000 12882.8000 59.9200
OCTH-97166-OT EVAL MODERATE COMPLEXITY 6 6.000000 348.6600 58.1100
OCTH-97166TL-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97167-OT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97167TL-OT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97162-PT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97163-PT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
SCREEN-T1023-SCREENING 5 5.000000 269.9000 53.9800
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 3 3.000000 174.3300 58.1100
SPCH-92523TL-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 58.1100 58.1100
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 2 3.000000 109.4300 36.4767
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 9 49.000000 2484.7800 50.7098
SPL-92526TL-TREATMENT OF SWALLOWING DYSFUNCTION 1 1.000000 58.1100 58.1100
Subtotal (Total Children Is Unduplicated) 164 488.000000 32328.3700 66.2467
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 36 38.250000 1943.8200 50.8188
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 19 17.750000 887.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 9 9.500000 237.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 35 49.000000 2450.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 2 2.000000 100.0000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 23 26.500000 1325.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 1 0.250000 12.5000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 9 8.250000 475.0000 57.5758
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 20 35.000000 1750.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 2 1.000000 50.0000 50.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 190 263.250000 0.0000 0.0000
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 4 4.000000 200.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 240 985.250000 53209.0000 54.0056
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 20 87.000000 4698.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 211 965.000000 14469.0000 14.9938
INTR-T1013-INTERPRETER 1 1.000000 50.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 198 795.000000 9540.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 11 28.000000 2276.9600 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 4 13.000000 1057.1600 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 3 8.000000 520.9600 65.1200
OCCT-97530TLGO-OT SESSION BY LICENSED OT 24 92.500000 7522.1000 81.3200
OCCT-97530TLHM-OT SESSION BY OT ASST 3 5.000000 325.6000 65.1200
PHY-97110-PT SESSION BY LICENSED PT 28 119.500000 8585.3100 71.8436
PHY-97110TL-PT SESSION BY LICENSED PT 18 52.750000 4238.3100 80.3471
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 25 127.750000 9782.0300 76.5717
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 16 70.000000 5733.0600 81.9009
TRAV-TRAVS-Travel by mile 240 16203.00000 7208.0200 0.4449
Subtotal (Total Children Is Unduplicated) 414 20007.50000 138646.8300 6.9297
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Total 22930.000000 260525.1500 11.3618
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Number of Children (Unduplicated) With at Least One Service 894
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Center 52
Flag Claims Units Chgs Paid
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R 51 54.000000 3595.9900 0.0000
U 0 0.000000 0.0000 0.0000
B 537 565.250000 23844.6600 0.0000
P 1421 1483.750000 76893.1900 75951.6700
D 45 48.750000 4001.6100 0.0000
S 37 40.250000 1592.3600 32.3900
H 72 79.000000 6082.5500 0.0000
T 3429 18593.500000 67633.1900 59049.4100
3060 2056.250000 76571.9000 30.0000
Other 8 9.250000 309.7000 281.8000
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Total 8660 22930.000000 260525.1500 135345.2700