CMS/EIP Fiscal Report Center: 05
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:GR
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 4 2.500000 125.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 2 4.000000 323.9200 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 1.500000 121.4700 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 2 3.500000 209.7200 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 5 7.500000 449.4000 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 24 44.500000 3603.6100 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 23 40.000000 3239.2000 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 7 13.500000 1093.2300 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 15 22.500000 1822.0500 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 4 7.000000 566.8600 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 30 54.000000 3235.6800 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 32 59.500000 3565.2400 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 2 4.000000 323.9200 80.9800
OCTH-97167-OT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97161-PT EVAL LOW 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 2 2.000000 116.2200 58.1100
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 10.3600 10.3600
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 4 10.000000 538.8500 53.8850
Subtotal (Total Children Is Unduplicated) 97 284.000000 19842.9800 69.8696
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 13 14.000000 849.9500 60.7107
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 63 61.250000 3062.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 27 28.500000 1425.0000 50.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 43 40.000000 2000.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 25 59.500000 2975.0000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 19 18.500000 925.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 22 54.000000 2700.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 14 11.000000 550.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 5 2.500000 125.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 24 19.000000 950.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 9 8.500000 425.0000 50.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 12 40.000000 1080.0000 27.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 198 852.000000 46008.0000 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 8 16.000000 864.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 422 2319.000000 34773.0000 14.9948
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 243 1014.000000 12029.3400 11.8633
OCCT-97530-OT SESSION BY LICENSED OT 16 48.500000 3944.0200 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 1 8.000000 650.5600 81.3200
PHY-97110-PT SESSION BY LICENSED PT 7 15.500000 1136.2000 73.3032
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 11 19.500000 1399.1300 71.7503
TRAV-TRAVS-Travel by mile 557 50476.00000 22469.2800 0.4451
Subtotal (Total Children Is Unduplicated) 655 55125.25000 140340.9800 2.5459
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Total 55409.250000 160183.9600 2.8909
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Number of Children (Unduplicated) With at Least One Service 669
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Center 05
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 7320 51556.250000 150963.3100 150963.3100
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
420 3853.000000 9220.6500 9220.6500
Other 0 0.000000 0.0000 0.0000
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Total 7740 55409.250000 160183.9600 160183.9600