CMS/EIP Fiscal Report Center: 09
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 Page: 1
List order: No List
Agency Filter:EIP DEI DEIP
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 3193 16769.50000 624459.5400 37.2378
TCM-T1017TL-TARGETED CASE MANAGEMENT 3417 28726.75000 1068625.1100 37.1997
Subtotal (Total Children Is Unduplicated) 3573 45496.25000 1693084.6500 37.2137
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 683 1132.000000 56600.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 12 19.500000 1567.1500 80.3667
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 6 11.500000 919.3100 79.9400
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 8 15.000000 1190.7800 79.3853
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 5 8.500000 676.3700 79.5729
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 4 7.000000 554.9000 79.2714
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 17 32.000000 1855.5600 57.9863
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 21 39.500000 2313.8000 58.5772
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 196 331.000000 26089.6400 78.8207
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 129 229.000000 18191.6000 79.4393
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 86 157.500000 12419.3400 78.8530
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 108 199.500000 15775.7800 79.0766
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 62 112.500000 8957.7600 79.6245
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 46 90.500000 7268.8900 80.3192
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 367 688.500000 40037.8600 58.1523
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 450 864.500000 51378.8700 59.4319
NUTR-97802-NUTRITIONAL EVAL, INITIAL 1 1.000000 50.0000 50.0000
OCTH-97166-OT EVAL MODERATE COMPLEXITY 10 11.000000 678.9300 61.7209
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 51.4100 51.4100
SPCH-92522TLGT-EVAL OF SPCH SOUND PROD 1 1.000000 58.1100 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 14 15.000000 891.2700 59.4180
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 4 4.000000 232.4400 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 2 5.000000 290.5500 58.1100
Subtotal (Total Children Is Unduplicated) 1867 3976.000000 248050.3200 62.3869
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 36 53.750000 2687.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 47 74.000000 3700.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 34 35.750000 893.7500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 7 7.000000 350.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 2 2.000000 100.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 1 1.000000 50.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 4 5.000000 250.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 1 1.000000 50.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 14 14.000000 700.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 10 11.000000 550.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 1 1.000000 25.0000 25.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 114 628.750000 331.8000 0.5277
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 72 603.250000 31942.5000 52.9507
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 14 50.000000 2664.0000 53.2800
INTR-T1013-INTERPRETER 292 1487.500000 74225.0000 49.8992
OCCT-97530-OT SESSION BY LICENSED OT 8 53.000000 4263.1600 80.4370
OCCT-97530GO-OT SESSION BY LICENSED OT 7 37.750000 3051.1100 80.8241
OCCT-97530GOGT-OT SESSION BY LICENSED OT 6 7.000000 503.7200 71.9600
OCCT-97530GT-OT SESSION BY LICENSED OT 6 11.000000 791.5600 71.9600
OCCT-97530TLGO-OT SESSION BY LICENSED OT 4 49.000000 3975.3200 81.1290
OCCT-97530TLGOGT-OT SESSION BY LICENSED OT 2 2.000000 162.6400 81.3200
OCCT-97530TLGT-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 32 364.000000 28863.5700 79.2955
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 7 15.000000 1191.7200 79.4480
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 4 27.000000 2195.6400 81.3200
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 1 7.000000 569.2400 81.3200
Subtotal (Total Children Is Unduplicated) 483 3548.750000 164168.5500 46.2610
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Total 53021.000000 2105303.5200 39.7070
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Number of Children (Unduplicated) With at Least One Service 3684
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Center 09
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 35549 35741.250000 1386513.8600 1377255.1100
D 1 2.500000 93.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 13339 14860.000000 622162.9400 619726.7800
T 951 1009.000000 41115.5100 41115.5100
1281 1400.250000 54905.5700 0.0000
Other 4 8.000000 512.6400 0.0000
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Total 51125 53021.000000 2105303.5200 2038097.4000