CMS/EIP Fiscal Report Center: 06
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
EXIT-EXIT-COS Exit 365 342.500000 16921.2500 49.4051
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 100.0000 50.0000
Subtotal (Total Children Is Unduplicated) 365 344.500000 17021.2500 49.4086
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 210 249.250000 12152.0000 48.7543
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 198 252.000000 12225.0000 48.5119
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 125 126.500000 3056.2500 24.1601
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 10 24.000000 1200.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 9 18.250000 912.5000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 4 7.250000 181.2500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 6 7.500000 375.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 8 20.000000 1000.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 5 6.750000 187.5000 27.7778
CONPF-CONPF-CONSULT, PT, FACE TO FACE 4 15.000000 725.0000 48.3333
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 4 6.500000 306.2500 47.1154
CONPP-CONPP-CONSULT, PT, PHONE 1 4.000000 100.0000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 2 5.000000 250.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 456 8527.000000 441558.5000 51.7836
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 116 1066.750000 55326.0000 51.8641
EPIC-99601-Early Steps Professional Development Fee 678 11857.00000 176496.0000 14.8854
INTR-T1013-INTERPRETER 46 866.500000 54690.0000 63.1160
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 601 9877.000000 116370.0000 11.7819
OCCT-97530-OT SESSION BY LICENSED OT 3 46.500000 2181.9000 46.9226
OCCT-97530HM-OT SESSION BY OT ASST 1 7.000000 172.8000 24.6857
OCCT-97530HMGT-OT SESSION BY OT ASST 2 9.000000 518.4000 57.6000
PHY-97110-PT SESSION BY LICENSED PT 4 17.750000 1443.4300 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 5.000000 406.6000 81.3200
PHY-97110HM-PT SESSION BY PT ASST 2 18.750000 1044.9700 55.7317
PHY-97110HMGT-PT SESSION BY PT ASST 2 15.000000 935.7600 62.3840
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 13 206.000000 16253.5000 78.9005
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 3 38.500000 3005.9200 78.0758
Subtotal (Total Children Is Unduplicated) 1146 33299.75000 903074.5300 27.1196
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Total 33644.250000 920095.7800 27.3478
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Number of Children (Unduplicated) With at Least One Service 1173
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Center 06
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 32095 32528.250000 888371.1200 888371.1200
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
1083 1116.000000 31724.6600 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 33178 33644.250000 920095.7800 888371.1200