CMS/EIP Fiscal Report Center: 01
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 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 40 51.000000 2473.5000 48.5000
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 2 2.000000 15.8400 7.9200
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 2 2.000000 63.6200 31.8100
EXIT-EXIT-COS Exit 358 348.500000 17712.5000 50.8250
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 6 11.000000 650.2800 59.1164
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 3 5.500000 311.8800 56.7055
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 2 4.000000 323.9200 80.9800
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 18 31.500000 2338.8700 74.2498
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 52 96.500000 6673.1100 69.1514
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 6 15.000000 1214.7000 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 5 8.500000 688.3300 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 177 318.000000 18391.4900 57.8349
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 132 236.500000 13767.1900 58.2122
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 81 147.500000 11744.3400 79.6226
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 57 111.000000 8726.7800 78.6196
OCTF-97168GT-OT RE-EVAL EST PLAN CARE 1 1.000000 58.1100 58.1100
OCTH-97165-OT EVAL LOW COMPLEXITY 10 10.000000 581.1000 58.1100
OCTH-97165GT-OT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97166-OT EVAL MODERATE 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 5 5.000000 290.5500 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 7 7.000000 393.3700 56.1957
PSTH-97162-PT EVAL MODERATE COMPLEXITY 4 4.000000 232.4400 58.1100
PSTH-97163-PT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97163GT-PT EVAL HIGH COMPLEXITY 2 2.000000 109.5200 54.7600
SPCH-92521-EVAL OF SPEECH FLUENCY 6 20.000000 1148.8000 57.4400
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 10 10.000000 554.3000 55.4300
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 58.1100 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 6 67.000000 4881.6400 72.8603
Subtotal (Total Children Is Unduplicated) 910 1521.500000 93798.6900 61.6488
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 487 608.750000 30401.5000 49.9409
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 364 488.750000 24525.0000 50.1790
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 171 164.500000 4214.0000 25.6170
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 294 788.750000 39477.0000 50.0501
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 336 1379.500000 59430.0000 43.0808
CONIP-CONIP-CONSULT, ITDS PHONE 35 40.000000 1025.0000 25.6250
CONOF-CONOF-CONSULT, OT, FACE TO FACE 47 114.250000 5712.5000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 128 515.750000 25787.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 6 6.250000 156.2500 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 69 102.500000 5125.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 116 367.500000 18375.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 2 4.500000 112.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 180 519.750000 22784.4600 43.8373
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 139 453.250000 22662.5000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 17 16.000000 500.0000 31.2500
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 1 1.000000 54.0000 54.0000
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 6 8.000000 412.0000 51.5000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1177 16739.50000 887002.0000 52.9886
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 242 1447.250000 76170.5000 52.6312
EPIC-99601-Early Steps Professional Development Fee 596 8498.000000 127470.0000 15.0000
INTR-T1013-INTERPRETER 422 1169.000000 59740.1000 51.1036
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 2839 49253.00000 591036.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 41 562.750000 44519.9500 79.1114
OCCT-97530GO-OT SESSION BY LICENSED OT 2 5.000000 406.6000 81.3200
OCCT-97530GOGT-OT SESSION BY LICENSED OT 1 2.000000 162.6400 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 14 47.000000 3634.8400 77.3370
PHY-97110-PT SESSION BY LICENSED PT 101 1747.000000 134531.2100 77.0070
PHY-97110GPGT-PT SESSION BY LICENSED PT 1 3.000000 243.9600 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 16 77.250000 6058.8300 78.4315
SENS-V5264-EARMOLD 1 2.000000 36.0000 18.0000
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 179 2377.250000 184568.7800 77.6396
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 19 169.000000 13223.6000 78.2462
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 8 54.000000 3516.4800 65.1200
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 1 6.000000 390.7200 65.1200
SPL-92508HA-GROUP SPL SESSION PER CHILD 4 31.000000 458.8800 14.8026
TRAV-TRAVS-Travel by mile 931 167722.0000 74726.6800 0.4455
Subtotal (Total Children Is Unduplicated) 3385 255491.0000 2468651.9800 9.6624
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Total 257012.500000 2562450.6700 9.9701
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Number of Children (Unduplicated) With at Least One Service 3493
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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 85056 204316.250000 2134017.6600 2133814.4800
D 1997 4151.000000 71722.7600 0.0000
S 9 13.000000 1026.7800 0.0000
H 6 10.500000 818.7000 0.0000
T 15239 48507.500000 354079.7700 351390.4000
15 14.250000 785.0000 54.0000
Other 0 0.000000 0.0000 0.0000
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Total 102322 257012.500000 2562450.6700 2485258.8800