CMS/EIP Fiscal Report Center: 07
Services beginning 07/01/2024 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
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 8 3.000000 111.6000 37.2000
TCM-T1017TL-TARGETED CASE MANAGEMENT 2 0.750000 27.9000 37.2000
Subtotal (Total Children Is Unduplicated) 10 3.750000 139.5000 37.2000
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Screening, Eval, and Assessment,Class #02
AUD-92626-EVAL OF AUD REHAB STATUS 1 1.000000 61.7100 61.7100
AUDE-92550-TYMPANOMETRY & REFLEX THRESH 1 1.000000 15.8400 15.8400
AUDE-92555-SPEECH AUD THRESHOLD (DETECTION) 7 7.000000 111.5800 15.9400
AUDE-92557-COMP AUDIO THRESHOLD EVAL/SPCH RECOG 5 9.000000 218.5200 24.2800
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 47 51.000000 417.2700 8.1818
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 42 45.000000 1399.6600 31.1036
AUDE-92582-CONDITIONED PLAY AUDIOMETRY 1 1.000000 45.0800 45.0800
AUDE-92587-OTOACOUSTIC EMISSIONS (LIMITED) 18 18.000000 269.2800 14.9600
AUDE-92588-OTOACOUSTIC EMISSIONS (COMP) 10 10.000000 229.3000 22.9300
EXIT-EXIT-COS Exit 391 436.000000 22850.0000 52.4083
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 6 12.000000 923.9200 76.9933
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 4 8.000000 607.8400 75.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 4.000000 323.9200 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 8 16.000000 941.0400 58.8150
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 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 72 143.000000 10464.3300 73.1771
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 58 116.000000 8418.3500 72.5720
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 41 82.000000 6458.8800 78.7668
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 4 8.000000 623.9200 77.9900
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 2 4.000000 311.9600 77.9900
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 141 282.000000 16570.3600 58.7601
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 41 82.000000 4789.6800 58.4107
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 76 153.000000 11663.0700 76.2292
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 32 64.000000 4711.1700 73.6120
OCTF-97168-OT RE-EVAL EST PLAN CARE 18 20.000000 1056.0400 52.8020
OCTH-97165-OT EVAL LOW COMPLEXITY 6 6.000000 285.9000 47.6500
OCTH-97166-OT EVAL MODERATE COMPLEXITY 39 39.000000 2154.0600 55.2323
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 6 7.000000 386.6700 55.2386
OCTH-97167-OT EVAL HIGH COMPLEXITY 12 12.000000 643.0700 53.5892
OCTH-97167GT-OT EVAL HIGH COMPLEXITY 2 2.000000 109.5200 54.7600
PSTF-97164-PT RE-EVAL EST PLAN CARE 31 48.000000 2642.8800 55.0600
PSTH-97161-PT EVAL LOW COMPLEXITY 6 6.000000 283.8300 47.3050
PSTH-97162-PT EVAL MODERATE COMPLEXITY 11 11.000000 529.8500 48.1682
PSTH-97162GT-PT EVAL MODERATE COMPLEXITY 2 2.000000 116.2200 58.1100
PSTH-97163-PT EVAL HIGH COMPLEXITY 13 13.000000 735.3300 56.5638
SPCH-92521-EVAL OF SPEECH FLUENCY 31 32.000000 1714.2400 53.5700
SPCH-92521GT-EVAL OF SPEECH FLUENCY 4 4.000000 232.4400 58.1100
SPCH-92522-EVAL OF SPCH SOUND PROD 1 1.000000 58.1100 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 90 100.000000 5505.0500 55.0505
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 10 10.000000 554.3000 55.4300
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 8 10.000000 543.2100 54.3210
SPCH-92610GT-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 20.2200 20.2200
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 22 271.000000 13578.3900 50.1048
Subtotal (Total Children Is Unduplicated) 875 2156.000000 124181.7300 57.5982
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 5 6.000000 8025.1200 1337.5200
AUD-92630-AUD REHAB PRELING HEARING LOSS 1 1.000000 69.3500 69.3500
AUDE-V5160-DISPENSING FEE BINAURAL 1 1.000000 231.6200 231.6200
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 275 296.500000 14825.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 650 938.000000 46900.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 88 85.500000 2137.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 560 1664.750000 83237.5000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 550 2204.000000 110137.5000 49.9716
CONIP-CONIP-CONSULT, ITDS PHONE 12 12.250000 306.2500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 272 572.750000 28637.5000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 283 811.000000 40525.0000 49.9692
CONOP-CONOP-CONSULT, OT, PHONE 3 3.000000 75.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 106 268.250000 13412.5000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 111 352.500000 17625.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 4 5.500000 137.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 327 805.250000 40262.5000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 313 835.000000 41750.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 17 23.000000 575.0000 25.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 1 4.000000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1082 19581.00000 1035667.0000 52.8914
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 267 1233.250000 65336.5000 52.9791
EPIC-99601-Early Steps Professional Development Fee 1376 24199.00000 363171.0000 15.0077
INTR-T1013-INTERPRETER 2 11.750000 902.8000 76.8340
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1995 40479.00000 486321.0000 12.0142
OCCT-97530-OT SESSION BY LICENSED OT 119 1752.750000 129271.6800 73.7536
OCCT-97530GO-OT SESSION BY LICENSED OT 1 2.000000 82.8400 41.4200
CMS/EIP Fiscal Report Center: 07
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 Page: 2
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
OCCT-97530GOGT-OT SESSION BY LICENSED OT 3 7.000000 569.2400 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 10 95.000000 7053.2800 74.2451
OCCT-97530HM-OT SESSION BY OT ASST 15 110.000000 6967.8400 63.3440
OCCT-97530HMGT-OT SESSION BY OT ASST 3 3.000000 195.3600 65.1200
PHY-97110-PT SESSION BY LICENSED PT 97 1794.250000 134904.3300 75.1870
PHY-97110GT-PT SESSION BY LICENSED PT 9 44.250000 3227.3100 72.9336
PHY-97110HM-PT SESSION BY PT ASST 1 20.000000 1241.9200 62.0960
SENS-V5261-BEHIND EAR DIGITAL BINAURAL HEARING AID 1 1.000000 980.7400 980.7400
SENS-V5264-EARMOLD 7 23.000000 416.9900 18.1300
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 244 3656.000000 269970.9200 73.8432
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 16 72.250000 5532.1700 76.5698
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 21 311.500000 17845.3100 57.2883
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 13 190.750000 11637.3500 61.0084
TRAV-TRAVS-Travel by mile 145 17093.00000 7608.3600 0.4451
Subtotal (Total Children Is Unduplicated) 2675 119569.0000 2997773.7800 25.0715
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Total 121728.750000 3122095.0100 25.6480
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Number of Children (Unduplicated) With at Least One Service 2700
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Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 105582 121741.000000 3123708.7200 3123708.7200
D 2 2.000000 139.4300 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
18 13.750000 498.5700 58.1100
Other 54 -28.000000 -2251.7100 -2251.7100
---------------------------------------------------------
Total 105656 121728.750000 3122095.0100 3121515.1200