CMS/EIP Fiscal Report Center: 07
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
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 1 1.000000 7.9200 7.9200
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 1 1.000000 31.8100 31.8100
AUDE-92588-OTOACOUSTIC EMISSIONS (COMP) 1 1.000000 23.1400 23.1400
EXIT-EXIT-COS Exit 141 161.250000 8600.0000 53.3333
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 4.000000 323.9200 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 119.8400 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 16 32.000000 2451.3600 76.6050
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 15 30.000000 2249.0100 74.9670
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 13 26.000000 1965.4800 75.5954
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 30 60.000000 3595.2000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 7 14.000000 838.8800 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 14 28.000000 2100.9700 75.0346
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 3 6.000000 448.3800 74.7300
OCTF-97168-OT RE-EVAL EST PLAN CARE 8 8.000000 464.8800 58.1100
OCTH-97165-OT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97166-OT EVAL MODERATE COMPLEXITY 14 14.000000 813.5400 58.1100
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97167-OT EVAL HIGH COMPLEXITY 2 2.000000 116.2200 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 11 11.000000 586.6100 53.3282
PSTH-97163-PT EVAL HIGH COMPLEXITY 5 5.000000 290.5500 58.1100
SPCH-92521-EVAL OF SPEECH FLUENCY 7 7.000000 337.1300 48.1614
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 17 17.000000 987.8700 58.1100
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 3 3.000000 174.3300 58.1100
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 4 5.000000 290.5500 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 13 69.000000 3453.4900 50.0506
Subtotal (Total Children Is Unduplicated) 280 511.250000 30549.2600 59.7541
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 2 2.000000 547.0600 273.5300
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 69 68.250000 3412.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 182 210.000000 10500.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 12 10.500000 262.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 207 349.750000 17487.5000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 249 470.000000 23500.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 1.000000 25.0000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 87 116.500000 5825.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 117 182.250000 9112.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 38 55.000000 2750.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 52 72.500000 3625.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 2 1.500000 37.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 113 155.500000 7775.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 122 181.250000 9062.5000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 607 4571.750000 246701.7000 53.9622
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 88 254.750000 13756.5000 54.0000
EPIC-99601-Early Steps Professional Development Fee 787 5760.000000 86385.0000 14.9974
INTR-T1013-INTERPRETER 1 2.000000 161.7000 80.8500
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1010 8648.000000 103651.0000 11.9855
OCCT-97530-OT SESSION BY LICENSED OT 58 358.000000 26719.9800 74.6368
OCCT-97530GT-OT SESSION BY LICENSED OT 3 24.000000 1608.1200 67.0050
OCCT-97530HM-OT SESSION BY OT ASST 8 39.000000 2539.6800 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 1 1.000000 65.1200 65.1200
PHY-97110-PT SESSION BY LICENSED PT 54 331.500000 25340.2800 76.4413
PHY-97110GT-PT SESSION BY LICENSED PT 1 2.750000 223.6300 81.3200
PHY-97110HM-PT SESSION BY PT ASST 1 7.000000 455.8400 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 111 765.750000 57915.3100 75.6321
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 8 12.750000 899.5500 70.5529
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 12 91.000000 4901.0300 53.8575
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 5 16.000000 946.9300 59.1831
TRAV-TRAVS-Travel by mile 51 3843.000000 1709.5600 0.4449
Subtotal (Total Children Is Unduplicated) 1548 26605.25000 667927.9900 25.1051
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Total 27116.500000 698477.2500 25.7584
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Number of Children (Unduplicated) With at Least One Service 1566
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Center 07
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 23477 27114.500000 698690.5700 698690.5700
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
3 3.000000 243.9600 0.0000
Other 15 -1.000000 -457.2800 -457.2800
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Total 23495 27116.500000 698477.2500 698233.2900