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
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 2.000000 100.0000 50.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 2 3.500000 283.4300 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 16 31.500000 2550.8700 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 14 28.000000 2267.4400 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 8 15.500000 1255.1900 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 24 44.000000 2636.4800 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 26 51.000000 3055.9200 59.9200
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
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 4 20.000000 1124.4200 56.2210
Subtotal (Total Children Is Unduplicated) 90 205.500000 13992.0700 68.0879
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EI Services,Class #03
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 3 12.000000 648.0000 54.0000
OCCT-97530-OT SESSION BY LICENSED OT 45 185.000000 15044.2000 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 8 44.500000 2897.8400 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 1 4.000000 260.4800 65.1200
PHY-97110-PT SESSION BY LICENSED PT 68 264.000000 21468.4800 81.3200
PHY-97110HM-PT SESSION BY PT ASST 2 11.000000 716.3200 65.1200
PHY-97110HMGT-PT SESSION BY PT ASST 1 1.000000 65.1200 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 97 497.500000 40380.9800 81.1678
Subtotal (Total Children Is Unduplicated) 186 1020.000000 81531.4200 79.9328
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Total 1225.500000 95523.4900 77.9465
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Number of Children (Unduplicated) With at Least One Service 262
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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 636 673.750000 52309.5300 52309.5300
D 7 7.000000 569.2400 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 396 383.250000 30071.1800 30071.1800
104 112.000000 8986.2300 0.0000
Other 25 49.500000 3587.3100 0.0000
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Total 1168 1225.500000 95523.4900 82380.7100