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
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 1027 1951.750000 89051.0400 45.6263
TCM-T1017TL-TARGETED CASE MANAGEMENT 712 2262.250000 103106.9400 45.5772
Subtotal (Total Children Is Unduplicated) 1310 4214.000000 192157.9800 45.5999
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 128 228.500000 11425.0000 50.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 2 3.500000 283.4300 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 4 7.500000 607.3500 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 2 4.000000 323.9200 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 9 17.500000 1417.1500 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 10 17.000000 1376.6600 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 5 10.000000 809.8000 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 14 25.000000 1498.0000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 13 26.000000 1557.9200 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
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 8 60.000000 3486.6000 58.1100
Subtotal (Total Children Is Unduplicated) 211 526.000000 29241.9600 55.5931
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 93 161.750000 8087.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 6 8.500000 425.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 50 56.500000 1412.5000 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 2 2.000000 50.0000 25.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 9 9.000000 450.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 20 25.000000 1250.0000 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 513 2304.500000 124227.0000 53.9063
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 2 4.000000 216.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 940 4910.000000 73605.0000 14.9908
INTR-T1013-INTERPRETER 52 223.750000 10987.5000 49.1061
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 457 2057.000000 24276.0000 11.8017
OCCT-97530-OT SESSION BY LICENSED OT 68 248.000000 19760.7600 79.6805
OCCT-97530GO-OT SESSION BY LICENSED OT 2 8.250000 670.8900 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 13 77.000000 4965.8300 64.4913
OCCT-97530HMGT-OT SESSION BY OT ASST 1 4.000000 260.4800 65.1200
PHY-97110-PT SESSION BY LICENSED PT 83 341.000000 27730.1200 81.3200
PHY-97110HM-PT SESSION BY PT ASST 7 46.000000 2995.5200 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 104 394.750000 31918.1000 80.8565
TRAV-TRAVS-Travel by mile 482 39702.00000 17660.2200 0.4448
Subtotal (Total Children Is Unduplicated) 1423 50647.50000 351323.4200 6.9366
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Total 55387.500000 572723.3600 10.3403
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Number of Children (Unduplicated) With at Least One Service 1890
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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 10529 35279.000000 324991.3200 324991.3200
D 96 252.000000 4912.1200 0.0000
S 1 1.000000 54.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 4580 9445.250000 162187.9600 162187.9600
2628 10392.250000 79288.8000 11.4200
Other 9 18.000000 1289.1600 0.0000
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Total 17843 55387.500000 572723.3600 487190.7000