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
Agency Filter:EXT
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
TCM-T1017TL-TARGETED CASE MANAGEMENT 74 116.000000 5222.5600 45.0221
Subtotal (Total Children Is Unduplicated) 74 116.000000 5222.5600 45.0221
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 91 182.000000 9100.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 1 2.000000 161.9600 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-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 1.500000 89.8800 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 5 8.500000 509.3200 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 10 14.000000 1133.7200 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 30 47.500000 3804.4300 80.0933
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 30 54.500000 4413.4100 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 92 173.000000 14009.5400 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 24 47.500000 3846.5500 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 19 37.000000 2996.2600 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 73 127.500000 7639.8000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 110 196.000000 11744.3200 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
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 1 1.000000 58.1100 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 13 82.000000 4727.2400 57.6493
Subtotal (Total Children Is Unduplicated) 430 1111.000000 71451.1100 64.3124
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 108 190.000000 9500.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 60 66.750000 1668.7500 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 28 35.000000 1750.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1238 6741.000000 363690.0000 53.9519
EPIC-99601-Early Steps Professional Development Fee 1054 7020.000000 105255.0000 14.9936
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 506 2582.000000 30576.0000 11.8420
OCCT-97530-OT SESSION BY LICENSED OT 139 724.000000 58469.0800 80.7584
OCCT-97530GO-OT SESSION BY LICENSED OT 2 8.250000 670.8900 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 254 1468.250000 119139.4000 81.1438
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) 1504 64365.75000 811465.1500 12.6071
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Total 65592.750000 888138.8200 13.5402
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Number of Children (Unduplicated) With at Least One Service 1717
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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 11313 37661.750000 349691.2800 349691.2800
D 145 312.000000 7128.4600 0.0000
S 1 1.000000 54.0000 0.0000
H 222 340.500000 21100.5100 0.0000
T 5434 12665.000000 176453.4100 176453.4100
6580 14435.000000 321453.7400 0.0000
Other 91 177.500000 12257.4200 0.0000
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Total 23786 65592.750000 888138.8200 526144.6900