CMS/EIP Fiscal Report Center: 01
Services beginning 04/01/2025 ending 06/30/2025 Date of Report:07/19/2025 Page: 1
List order: No List
Payclass Filters:TPIN
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 1 1.000000 48.5000 48.5000
EXIT-EXIT-COS Exit 3 3.000000 150.0000 50.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 3 5.000000 299.6000 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 6 9.500000 769.3100 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 1 1.500000 89.8800 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 2 5.000000 298.7200 59.7440
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 1 1.500000 121.4700 80.9800
OCTH-97165-OT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 1 1.000000 58.1100 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 4 4.000000 232.4400 58.1100
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 2 2.000000 116.2200 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 1 1.000000 58.1100 58.1100
Subtotal (Total Children Is Unduplicated) 25 42.500000 2802.3400 65.9374
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EI Services,Class #03
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 1 1.000000 50.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 2 2.000000 50.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 237 1770.500000 95593.5000 53.9924
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 20 81.750000 4414.5000 54.0000
OCCT-97530-OT SESSION BY LICENSED OT 22 122.750000 9982.0300 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 2 4.000000 325.2800 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 4 11.000000 894.5200 81.3200
PHY-97110-PT SESSION BY LICENSED PT 36 279.750000 22664.1900 81.0159
PHY-97110GT-PT SESSION BY LICENSED PT 5 13.750000 1118.1500 81.3200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 55 371.750000 29998.5600 80.6955
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 7 13.000000 1057.1600 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 1 10.000000 651.2000 65.1200
SPL-92508HA-GROUP SPL SESSION PER CHILD 2 6.000000 94.5600 15.7600
Subtotal (Total Children Is Unduplicated) 297 2687.250000 166893.6500 62.1057
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Total 2729.750000 169695.9900 62.1654
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Number of Children (Unduplicated) With at Least One Service 304
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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 1294 1289.000000 78741.8700 78741.8700
D 38 38.000000 2579.3000 0.0000
S 2 2.000000 162.6400 0.0000
H 179 191.000000 13228.6800 0.0000
T 1151 1148.750000 70654.5900 68544.2100
59 61.000000 4328.9100 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 2723 2729.750000 169695.9900 147286.0800