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
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 53 76.500000 3825.0000 50.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
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 1 2.000000 161.9600 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 2 4.000000 323.9200 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 5 7.500000 607.3500 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 3 6.000000 485.8800 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 10 17.000000 1018.6400 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 8 16.000000 958.7200 59.9200
Subtotal (Total Children Is Unduplicated) 78 138.500000 8150.7800 58.8504
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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 10 20.000000 1080.0000 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 2 4.000000 216.0000 54.0000
INTR-T1013-INTERPRETER 52 223.750000 10987.5000 49.1061
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 1 3.000000 243.9600 81.3200
Subtotal (Total Children Is Unduplicated) 108 326.500000 13439.9600 41.1637
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Total 4679.000000 213748.7200 45.6826
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Number of Children (Unduplicated) With at Least One Service 1381
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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 2047 2235.500000 101799.9000 101799.9000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 1874 1923.250000 87952.8300 87952.8300
545 520.250000 23995.9900 11.4200
Other 0 0.000000 0.0000 0.0000
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Total 4466 4679.000000 213748.7200 189764.1500