CMS/EIP Fiscal Report Center: 03
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 Page: 1
List order: No List
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 1159 908.750000 33786.9000 37.1795
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 10 69.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 2345 10394.75000 386628.9000 37.1946
Subtotal (Total Children Is Unduplicated) 2480 11372.50000 420415.8000 36.9678
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 8 8.000000 388.0000 48.5000
EXIT-EXIT-COS Exit 23 20.500000 1012.5000 49.3902
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 14 26.000000 2004.7300 77.1050
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 15 29.000000 2196.2200 75.7317
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 4 7.500000 455.4100 60.7213
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 19 35.500000 2100.6400 59.1730
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 3 4.000000 226.4200 56.6050
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 9 14.500000 1174.2100 80.9800
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 1 1.500000 121.4700 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 220 404.500000 29713.6800 73.4578
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 2 2.000000 79.6000 39.8000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 236 443.000000 34127.5600 77.0374
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 26 47.000000 3235.2000 68.8340
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 302 583.000000 34148.8100 58.5743
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 17 30.500000 1798.8300 58.9780
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 34 62.000000 5020.7600 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 3 5.500000 445.3900 80.9800
OCTH-97165-OT EVAL LOW COMPLEXITY 6 6.000000 348.6600 58.1100
OCTH-97166-OT EVAL MODERATE COMPLEXITY 5 6.000000 315.1600 52.5267
OCTH-97167-OT EVAL HIGH COMPLEXITY 3 3.000000 110.4400 36.8133
PSTH-97161-PT EVAL LOW COMPLEXITY 8 9.000000 509.5900 56.6211
PSTH-97162-PT EVAL MODERATE COMPLEXITY 15 40.000000 2151.0400 53.7760
PSTH-97163-PT EVAL HIGH COMPLEXITY 5 7.000000 393.3700 56.1957
SCREEN-T1023-SCREENING 24 27.000000 1441.5400 53.3904
SPCH-92521-EVAL OF SPEECH FLUENCY 8 8.000000 451.4800 56.4350
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 37 42.000000 2291.7200 54.5648
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.4400 51.4400
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 44.8600 44.8600
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 1 8.000000 411.2800 51.4100
Subtotal (Total Children Is Unduplicated) 715 1882.000000 126770.0100 67.3592
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 2 2.000000 187.5600 93.7800
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 243 283.000000 13635.3500 48.1814
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 292 353.000000 16789.7900 47.5631
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 10 7.500000 187.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 15 29.000000 1412.5000 48.7069
CONIP-CONIP-CONSULT, ITDS PHONE 2 2.000000 50.0000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 78 189.000000 9450.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 41 90.000000 4500.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 57 129.750000 6487.5000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 7 10.000000 500.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 112 257.250000 12862.5000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 37 93.000000 4650.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 2 2.500000 75.0000 30.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 5 28.000000 0.0000 0.0000
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 454 4719.250000 249720.4600 52.9153
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 106 342.500000 18172.0000 53.0569
EPIC-99601-Early Steps Professional Development Fee 601 5988.000000 89484.0000 14.9439
INTR-T1013-INTERPRETER 40 168.250000 13367.5000 79.4502
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 689 6779.000000 81324.0000 11.9965
OCCT-97530-OT SESSION BY LICENSED OT 61 509.750000 38266.0400 75.0682
OCCT-97530GOGT-OT SESSION BY LICENSED OT 4 11.000000 875.8000 79.6182
OCCT-97530GT-OT SESSION BY LICENSED OT 4 26.000000 2030.0800 78.0800
PHY-97110-PT SESSION BY LICENSED PT 71 659.750000 49178.7800 74.5415
PHY-97110GT-PT SESSION BY LICENSED PT 18 22.250000 1638.0100 73.6184
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 131 1326.000000 98477.1400 74.2663
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 8 9.750000 748.4100 76.7600
TRAV-TRAVS-Travel by mile 936 199995.0000 88948.2400 0.4448
Subtotal (Total Children Is Unduplicated) 1209 222033.5000 803068.1600 3.6169
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Total 235288.000000 1350253.9700 5.7387
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Number of Children (Unduplicated) With at Least One Service 2536
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Center 03
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 27433 180042.750000 722433.3100 722433.3100
D 0 0.000000 0.0000 0.0000
S 6 5.000000 161.2000 161.2000
H 481 2543.250000 13036.1700 13036.1700
T 1430 978.250000 36259.1600 36259.1600
22842 51718.750000 578364.1300 25.0000
Other 0 0.000000 0.0000 0.0000
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Total 52192 235288.000000 1350253.9700 771914.8400