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:EIP DEI DEIP
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 1380 4212.750000 191915.0800 45.5558
Subtotal (Total Children Is Unduplicated) 1551 6164.750000 280977.5400 45.5781
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 53 76.500000 3825.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 2 2.500000 202.4500 80.9800
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 3.500000 283.4300 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 4 6.500000 389.4800 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 2 3.500000 209.7200 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 33 58.500000 4737.3300 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 22 40.000000 3239.2000 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 27 49.500000 3966.3900 80.1291
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 19 33.500000 2712.8300 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 10 15.500000 1255.1900 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 27 51.000000 4129.9800 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 59 107.500000 6441.4000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 100 189.000000 11324.8800 59.9200
OCTH-97166-OT EVAL MODERATE COMPLEXITY 2 2.000000 116.2200 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 1 4.000000 232.4400 58.1100
Subtotal (Total Children Is Unduplicated) 297 646.000000 43286.0100 67.0062
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 4 5.750000 287.5000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 6 8.500000 425.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 2 3.000000 75.0000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 1 1.000000 50.0000 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 28 74.000000 3996.0000 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 5 14.000000 756.0000 54.0000
INTR-T1013-INTERPRETER 52 223.750000 10987.5000 49.1061
OCCT-97530-OT SESSION BY LICENSED OT 2 4.000000 325.2800 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 4 13.000000 1057.1600 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
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 12 26.000000 2114.3200 81.3200
Subtotal (Total Children Is Unduplicated) 113 435.750000 20616.3500 47.3123
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Total 7246.500000 344879.9000 47.5926
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Number of Children (Unduplicated) With at Least One Service 1650
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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 2119 2347.750000 109729.5000 109729.5000
D 1 2.000000 161.9600 0.0000
S 0 0.000000 0.0000 0.0000
H 1114 1381.250000 70075.1700 70075.1700
T 1923 1994.500000 92940.3100 92940.3100
1415 1519.000000 71853.1200 11.4200
Other 1 2.000000 119.8400 0.0000
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Total 6573 7246.500000 344879.9000 272756.4000