CMS/EIP Fiscal Report Center: 54
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
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 3 6.000000 485.8800 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 5 11.000000 659.1200 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 4 9.500000 569.2400 59.9200
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 4 8.000000 647.8400 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 4 8.000000 647.8400 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 4 8.000000 647.8400 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 38 82.000000 4913.4400 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 35 65.500000 3924.7600 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 8 16.000000 1295.6800 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 2 4.000000 323.9200 80.9800
Subtotal (Total Children Is Unduplicated) 97 220.000000 14277.5200 64.8978
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 12 14.000000 3228.9400 230.6386
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 31 23.500000 1175.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 48 46.250000 2312.5000 50.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 40 45.750000 2287.5000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 6 7.000000 350.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 0.500000 12.5000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 1 1.000000 50.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 2 1.250000 62.5000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 1 1.000000 50.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 1 1.000000 50.0000 50.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 1 0.500000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 2 20.000000 540.0000 27.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 437 1663.250000 89815.5000 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 133 218.000000 11772.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 337 1208.000000 18120.0000 15.0000
INTR-T1013-INTERPRETER 2 4.000000 137.8600 34.4650
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 250 786.000000 9432.0000 12.0000
PHY-97110-PT SESSION BY LICENSED PT 23 64.000000 5204.4800 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 3 4.000000 325.2800 81.3200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 39 134.000000 10896.8800 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 8 10.500000 853.8600 81.3200
TRAV-TRAVS-Travel by mile 538 27974.00000 12444.6500 0.4449
Subtotal (Total Children Is Unduplicated) 600 32227.50000 169121.4500 5.2477
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Total 32447.500000 183398.9700 5.6522
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Number of Children (Unduplicated) With at Least One Service 639
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Center 54
Flag Claims Units Chgs Paid
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R 2 1.500000 121.9800 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 4 3.750000 134.2000 0.0000
H 0 0.000000 0.0000 0.0000
T 1335 8173.580000 28442.7900 28442.7900
4912 24268.670000 154700.0000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 6253 32447.500000 183398.9700 28442.7900