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
Payclass Filters:GR
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 1856 11072.25000 412292.8000 37.2366
TCM-T1017TL-TARGETED CASE MANAGEMENT 1093 10057.25000 374183.5600 37.2054
Subtotal (Total Children Is Unduplicated) 1989 21129.50000 786476.3600 37.2217
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 656 1088.000000 54400.0000 50.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 119.8400 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 5 8.000000 617.9400 77.2425
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 1 1.500000 112.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 2 4.000000 311.9600 77.9900
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 7 13.000000 986.9600 75.9200
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 9 16.000000 903.4700 56.4669
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 4 7.000000 388.5000 55.5000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.4100 51.4100
Subtotal (Total Children Is Unduplicated) 676 1146.500000 58315.5400 50.8640
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 33 51.250000 2562.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 47 74.000000 3700.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 30 31.750000 793.7500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 6 6.000000 300.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 1 1.000000 50.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 3 4.000000 200.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 1 1.000000 50.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 13 13.000000 650.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 6 7.000000 350.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 1 1.000000 25.0000 25.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 84 532.000000 211.9600 0.3984
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 26 278.250000 14647.5000 52.6415
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 7 11.000000 590.0000 53.6364
INTR-T1013-INTERPRETER 121 643.500000 32175.0000 50.0000
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 7 14.000000 1082.3200 77.3086
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 1 2.000000 143.9200 71.9600
Subtotal (Total Children Is Unduplicated) 272 1670.750000 57531.9500 34.4348
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Total 23946.750000 902323.8500 37.6804
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Number of Children (Unduplicated) With at Least One Service 2046
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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 24081 23302.000000 877695.6300 875914.3800
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 376 368.250000 13790.1000 13790.1000
250 276.500000 10838.1200 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 24707 23946.750000 902323.8500 889704.4800