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
Payclass Filters:GR
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 34 43.000000 2085.5000 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 333 322.500000 16450.0000 51.0078
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 1.500000 89.8800 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 2 4.000000 300.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 8 14.000000 852.6000 60.9000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 13 21.500000 1121.9800 52.1851
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 11 19.000000 1063.3400 55.9653
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 7 13.000000 983.9700 75.6900
OCTH-97165-OT EVAL LOW COMPLEXITY 3 3.000000 174.3300 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
PSTH-97161-PT EVAL LOW COMPLEXITY 2 2.000000 116.2200 58.1100
PSTH-97163GT-PT EVAL HIGH COMPLEXITY 2 2.000000 109.5200 54.7600
SPCH-92521-EVAL OF SPEECH FLUENCY 2 15.000000 871.6500 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.4100 51.4100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 1 1.000000 51.4100 51.4100
Subtotal (Total Children Is Unduplicated) 409 470.500000 24679.4500 52.4537
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 430 552.750000 27601.5000 49.9349
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 309 432.000000 21662.5000 50.1447
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 143 140.750000 3619.2500 25.7140
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 245 714.500000 35750.0000 50.0350
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 268 1231.000000 52050.0000 42.2827
CONIP-CONIP-CONSULT, ITDS PHONE 28 33.000000 850.0000 25.7576
CONOF-CONOF-CONSULT, OT, FACE TO FACE 38 97.250000 4862.5000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 112 474.500000 23725.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 4 4.750000 118.7500 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 57 82.500000 4125.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 97 331.500000 16575.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 1 3.500000 87.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 165 488.750000 21234.4600 43.4465
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 119 410.500000 20525.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 13 12.000000 375.0000 31.2500
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 3 3.000000 162.0000 54.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 308 2945.000000 155276.0000 52.7253
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 63 363.500000 18957.0000 52.1513
EPIC-99601-Early Steps Professional Development Fee 403 6571.000000 98565.0000 15.0000
INTR-T1013-INTERPRETER 192 673.250000 33466.1000 49.7083
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1876 38507.00000 462084.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 14 65.500000 5214.1400 79.6052
OCCT-97530GO-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 4 6.000000 450.4800 75.0800
PHY-97110-PT SESSION BY LICENSED PT 41 333.750000 23622.0800 70.7778
PHY-97110GPGT-PT SESSION BY LICENSED PT 1 3.000000 243.9600 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 4 43.000000 3428.8800 79.7414
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 51 293.750000 21544.0000 73.3413
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 4 32.000000 2527.3600 78.9800
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 1 17.000000 1107.0400 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 12.000000 166.6400 13.8867
TRAV-TRAVS-Travel by mile 553 121638.0000 54200.8400 0.4456
Subtotal (Total Children Is Unduplicated) 2170 176523.0000 1114649.0200 6.3145
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Total 176993.500000 1139328.4700 6.4371
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Number of Children (Unduplicated) With at Least One Service 2191
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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 58019 152796.500000 1016793.6000 1016728.4200
D 922 2227.000000 18550.6200 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 6468 21966.750000 103852.6500 103746.1000
4 3.250000 131.6000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 65413 176993.500000 1139328.4700 1120474.5200