CMS/EIP Fiscal Report Center: 01
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
Payclass Filters:TPIN
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 2 1.500000 75.0000 50.0000
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 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 20 35.500000 2874.7900 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 9 17.500000 1337.1500 76.4086
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 8 12.500000 1012.2500 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 6 11.500000 931.2700 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 7 14.000000 1133.7200 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 3 4.500000 364.4100 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 40 72.500000 4344.2000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 15 28.000000 1677.7600 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 16 28.500000 2307.9300 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 12 23.500000 1903.0300 80.9800
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 1 1.000000 58.1100 58.1100
PSTH-97162-PT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
SPCH-92521-EVAL OF SPEECH FLUENCY 1 1.000000 58.1100 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 58.1100 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 1 3.000000 174.3300 58.1100
Subtotal (Total Children Is Unduplicated) 89 261.500000 18708.1900 71.5418
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EI Services,Class #03
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 1 1.250000 62.5000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 392 2067.000000 110534.0000 53.4756
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 45 122.000000 6588.0000 54.0000
OCCT-97530-OT SESSION BY LICENSED OT 15 58.000000 4716.5600 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
PHY-97110-PT SESSION BY LICENSED PT 44 265.750000 21285.7900 80.0970
PHY-97110GT-PT SESSION BY LICENSED PT 2 1.750000 142.3100 81.3200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 53 233.500000 18298.4420 78.3659
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 3 14.000000 1138.4800 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 2 7.000000 455.8400 65.1200
Subtotal (Total Children Is Unduplicated) 459 2772.250000 163353.2420 58.9244
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Total 3033.750000 182061.4320 60.0120
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Number of Children (Unduplicated) With at Least One Service 508
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Center 01
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 2284 2326.750000 137962.4020 137962.4000
D 74 73.750000 4760.9300 0.0000
S 0 0.000000 0.0000 0.0000
H 100 168.250000 12509.6300 0.0000
T 440 446.500000 25575.5500 25346.2600
12 18.500000 1252.9200 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 2910 3033.750000 182061.4320 163308.6600