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
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 13 13.000000 630.5000 48.5000
EXIT-EXIT-COS Exit 76 81.750000 4075.0000 49.8471
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 4 7.000000 507.7200 72.5314
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 10 19.500000 1456.4700 74.6908
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 2 8.000000 647.8400 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 40 72.000000 4314.2400 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 33 62.000000 3756.2800 60.5852
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 22 44.000000 3563.1200 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 17 34.000000 2631.8500 77.4074
OCTF-97168GT-OT RE-EVAL EST PLAN CARE 1 1.000000 58.1100 58.1100
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 3 3.000000 174.3300 58.1100
SPCH-92521-EVAL OF SPEECH FLUENCY 2 3.000000 174.3300 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 3 3.000000 174.3300 58.1100
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 58.1100 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 2 4.000000 232.4400 58.1100
Subtotal (Total Children Is Unduplicated) 222 366.250000 23218.7300 63.3959
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 123 127.250000 6369.5000 50.0550
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 142 157.500000 7937.5000 50.3968
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 47 40.000000 1038.5000 25.9625
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 84 105.250000 5277.0000 50.1378
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 168 348.750000 17392.5000 49.8710
CONIP-CONIP-CONSULT, ITDS PHONE 10 11.250000 281.2500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 3 10.000000 500.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 41 72.250000 3612.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 0.500000 12.5000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 16 22.000000 1100.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 47 77.750000 3887.5000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 1 1.000000 25.0000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 53 69.500000 3475.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 69 120.750000 6037.5000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 3 3.000000 75.0000 25.0000
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 2 2.000000 108.0000 54.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 628 4711.500000 254359.0000 53.9868
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 65 219.250000 11839.5000 54.0000
EPIC-99601-Early Steps Professional Development Fee 350 2700.000000 40500.0000 15.0000
INTR-T1013-INTERPRETER 122 281.250000 14237.9500 50.6238
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1534 12336.00000 148032.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 23 134.250000 10771.2100 80.2325
OCCT-97530GO-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 4 8.000000 650.5600 81.3200
PHY-97110-PT SESSION BY LICENSED PT 59 474.250000 38209.9400 80.5692
PHY-97110GPGT-PT SESSION BY LICENSED PT 1 3.000000 243.9600 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 7 17.750000 1422.3500 80.1324
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 76 562.000000 45469.6900 80.9069
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 7 25.000000 2033.0000 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 3 24.000000 1562.8800 65.1200
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 1 3.000000 195.3600 65.1200
SPL-92508HA-GROUP SPL SESSION PER CHILD 2 9.000000 141.8400 15.7600
TRAV-TRAVS-Travel by mile 501 49844.00000 22200.5100 0.4454
Subtotal (Total Children Is Unduplicated) 1900 72522.00000 649080.3200 8.9501
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Total 72888.250000 672299.0500 9.2237
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Number of Children (Unduplicated) With at Least One Service 1935
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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 11501 23680.000000 305593.9600 305593.9600
D 400 1102.250000 14404.3600 0.0000
S 3 5.500000 445.3900 0.0000
H 5 9.000000 728.8200 0.0000
T 15100 48086.500000 350884.7200 348195.3500
6 5.000000 241.8000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 27015 72888.250000 672299.0500 653789.3100