CMS/EIP Fiscal Report Center: 09
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
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 1027 1952.000000 89062.4600 45.6263
TCM-T1017TL-TARGETED CASE MANAGEMENT 1424 4328.750000 197137.6400 45.5415
Subtotal (Total Children Is Unduplicated) 1594 6280.750000 286200.1000 45.5678
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 143 258.500000 12925.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 3 4.500000 364.4100 80.9800
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 3.500000 283.4300 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 3.500000 283.4300 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 4 6.500000 526.3700 80.9800
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 5 8.000000 479.3600 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 7 12.000000 719.0400 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 43 72.500000 5871.0500 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 52 87.500000 7043.6300 80.4986
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 57 104.000000 8379.8000 80.5750
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 111 206.500000 16722.3700 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 34 63.000000 5101.7400 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 46 88.000000 7126.2400 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 132 235.000000 14081.2000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 210 385.000000 23069.2000 59.9200
NUTR-97802-NUTRITIONAL EVAL, INITIAL 22 73.000000 3650.0000 50.0000
NUTR-97803-NUTRITIONAL EVAL, FOLLOW-UP 13 47.000000 2350.0000 50.0000
OCTF-97168-OT RE-EVAL EST PLAN CARE 1 1.000000 58.1100 58.1100
OCTH-97165-OT EVAL LOW COMPLEXITY 3 3.000000 174.3300 58.1100
OCTH-97166-OT EVAL MODERATE COMPLEXITY 2 2.000000 116.2200 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 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 2 2.000000 116.2200 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 14 86.000000 4959.6800 57.6707
Subtotal (Total Children Is Unduplicated) 554 1757.000000 114737.1200 65.3029
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 110 195.750000 9787.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 6 8.500000 425.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 61 69.750000 1743.7500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 5 5.000000 250.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 1.000000 25.0000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 5 5.000000 200.0000 40.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 11 11.000000 550.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 29 36.000000 1800.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 1 1.000000 50.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 1 1.000000 25.0000 25.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 42 55.500000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1266 6815.000000 367686.0000 53.9525
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 5 14.000000 756.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 1054 7020.000000 105255.0000 14.9936
INTR-T1013-INTERPRETER 52 223.750000 10987.5000 49.1061
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 506 2582.000000 30576.0000 11.8420
OCCT-97530-OT SESSION BY LICENSED OT 141 728.000000 58794.3600 80.7615
OCCT-97530GO-OT SESSION BY LICENSED OT 6 21.250000 1728.0500 81.3200
OCCT-97530GOGT-OT SESSION BY LICENSED OT 1 3.750000 345.6100 92.1627
OCCT-97530GT-OT SESSION BY LICENSED OT 2 1.500000 121.9800 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 31 191.500000 12486.8700 65.2056
OCCT-97530HMGT-OT SESSION BY OT ASST 2 11.000000 716.3200 65.1200
PHY-97110-PT SESSION BY LICENSED PT 186 994.000000 80832.0800 81.3200
PHY-97110HM-PT SESSION BY PT ASST 12 86.000000 5600.3200 65.1200
PHY-97110HMGT-PT SESSION BY PT ASST 1 1.000000 65.1200 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 266 1494.250000 121253.7200 81.1469
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 1 4.000000 325.2800 81.3200
TRAV-TRAVS-Travel by mile 506 44220.00000 19670.0400 0.4448
Subtotal (Total Children Is Unduplicated) 1570 64801.50000 832081.5000 12.8405
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Total 72839.250000 1233018.7200 16.9279
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Number of Children (Unduplicated) With at Least One Service 2096
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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 13432 40009.500000 459420.7800 459420.7800
D 146 314.000000 7290.4200 0.0000
S 1 1.000000 54.0000 0.0000
H 1336 1721.750000 91175.6800 70075.1700
T 7357 14659.500000 269393.7200 269393.7200
7995 15954.000000 393306.8600 11.4200
Other 92 179.500000 12377.2600 0.0000
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Total 30359 72839.250000 1233018.7200 798901.0900