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
Agency Filter:EXT
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 1 1.000000 50.0000 50.0000
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 4 8.000000 567.8400 70.9800
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 15 29.500000 1767.6400 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 9 17.000000 1376.6600 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 4 8.000000 647.8400 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) 43 89.500000 6037.6600 67.4599
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EI Services,Class #03
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 391 2065.750000 110466.5000 53.4753
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 44 120.750000 6520.5000 54.0000
OCCT-97530-OT SESSION BY LICENSED OT 11 50.000000 4066.0000 81.3200
PHY-97110-PT SESSION BY LICENSED PT 42 263.750000 21123.1500 80.0878
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) 455 2757.500000 162261.2220 58.8436
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Total 2847.000000 168298.8820 59.1145
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Number of Children (Unduplicated) With at Least One Service 480
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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 0 0.000000 0.0000 0.0000
T 440 446.500000 25575.5500 25346.2600
0 0.000000 0.0000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 2798 2847.000000 168298.8820 163308.6600