CMS/EIP Fiscal Report Center: 06
Services beginning 04/01/2025 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 72 72.000000 3600.0000 50.0000
Subtotal (Total Children Is Unduplicated) 72 72.000000 3600.0000 50.0000
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 25 25.250000 1250.0000 49.5050
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 45 47.750000 2250.0000 47.1204
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 11 10.250000 243.7500 23.7805
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 3 4.000000 200.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 3 4.000000 200.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 4 6.000000 300.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 2 4.000000 175.0000 43.7500
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 2 3.500000 175.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 145 1202.250000 64472.0000 53.6261
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 24 137.500000 7425.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 287 2010.000000 30000.0000 14.9254
INTR-T1013-INTERPRETER 14 111.000000 6275.0000 56.5315
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 180 1298.000000 15408.0000 11.8706
PHY-97110-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 3.000000 243.9600 81.3200
PHY-97110HM-PT SESSION BY PT ASST 1 3.750000 244.2000 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 6 39.500000 3212.1400 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 1 7.000000 569.2400 81.3200
Subtotal (Total Children Is Unduplicated) 430 4918.750000 132749.6100 26.9885
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Total 4990.750000 136349.6100 27.3205
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Number of Children (Unduplicated) With at Least One Service 442
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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 3845 3885.750000 104492.9500 104492.9500
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
1072 1105.000000 31856.6600 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 4917 4990.750000 136349.6100 104492.9500