CMS/EIP Fiscal Report Center: 10
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
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 3162 9521.750000 432466.5200 45.4188
Subtotal (Total Children Is Unduplicated) 3162 9521.750000 432466.5200 45.4188
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Screening, Eval, and Assessment,Class #02
AUDE-92552-PURE TONE AUDIOMETRY -AIR ONLY 29 31.000000 622.3400 20.0755
AUDE-92555-SPEECH AUD THRESHOLD (DETECTION) 30 32.000000 484.5000 15.1406
AUDE-92558-OTOACOUSTIC EMISSIONS (SCREENING) 1 1.000000 6.8700 6.8700
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 31 31.000000 256.2500 8.2661
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 30 32.000000 954.3000 29.8219
AUDE-92588-OTOACOUSTIC EMISSIONS (COMP) 31 32.000000 733.4300 22.9197
AUDE-92650-AEP SCR AUDITORY POTENTIAL 1 1.000000 54.9000 54.9000
AUDE-92652-AEP THRSHLD EST MLT FREQ I&R 1 2.000000 141.4400 70.7200
AUDE-V5010-ASSESSMENT FOR HEARING AID 1 1.000000 45.3200 45.3200
AUDE-V5090-DISPENSING FEE PER HEARING AID 1 2.000000 231.6200 115.8100
EXIT-EXIT-COS Exit 101 102.000000 5100.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 25 48.000000 3887.0400 80.9800
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 2.500000 202.4500 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 3 5.000000 404.9000 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 22 45.500000 2726.3600 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 3 5.500000 445.3900 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 343 673.000000 54499.5400 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 10 18.000000 1457.6400 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 69 133.500000 10810.8300 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 4 6.000000 485.8800 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 69 130.000000 10527.4000 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 269 510.000000 30559.2000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 10 16.000000 958.7200 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 77 132.500000 10729.8500 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 1 1.000000 80.9800 80.9800
OCTH-97165-OT EVAL LOW COMPLEXITY 27 27.000000 1568.9700 58.1100
OCTH-97166-OT EVAL MODERATE COMPLEXITY 13 15.000000 755.4300 50.3620
PSTH-97161-PT EVAL LOW COMPLEXITY 22 22.000000 1278.4200 58.1100
PSTH-97162-PT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
SPCH-92521-EVAL OF SPEECH FLUENCY 25 28.000000 1578.6200 56.3793
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 6 6.000000 348.6600 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 57 383.000000 22256.1300 58.1100
Subtotal (Total Children Is Unduplicated) 679 2479.500000 164575.4100 66.3744
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 5.000000 499.7300 99.9460
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 28 33.500000 1675.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 119 87.250000 4362.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 2 1.250000 31.2500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 31 39.000000 1950.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 136 215.000000 10750.0000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 5 12.000000 600.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 24 41.000000 2050.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 7 8.500000 425.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 11 11.000000 550.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 117 188.500000 9425.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1228 8771.750000 473674.5000 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 303 1100.250000 59413.5000 54.0000
EPIC-99601-Early Steps Professional Development Fee 617 4342.000000 65145.0000 15.0035
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 986 8107.000000 97274.3500 11.9988
OCCT-97530-OT SESSION BY LICENSED OT 256 1287.500000 100877.0600 78.3511
OCCT-97530GT-OT SESSION BY LICENSED OT 2 7.000000 569.2400 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 50 231.000000 13708.3500 59.3435
OCCT-97530HMGT-OT SESSION BY OT ASST 1 2.000000 130.2400 65.1200
PHY-97110-PT SESSION BY LICENSED PT 357 1573.000000 125517.4200 79.7949
PHY-97110GT-PT SESSION BY LICENSED PT 2 1.000000 81.3200 81.3200
PHY-97110HM-PT SESSION BY PT ASST 40 155.750000 10077.3200 64.7019
PHY-97110HMGT-PT SESSION BY PT ASST 4 6.000000 390.7200 65.1200
SENS-V5050-IN EAR MONAURAL HEARING AID 1 2.000000 459.2200 229.6100
SENS-V5264-EARMOLD 2 4.000000 72.5200 18.1300
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 419 2096.500000 167809.0100 80.0425
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 10 19.500000 1585.7400 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 18 104.250000 6723.6400 64.4953
SPL-92508HA-GROUP SPL SESSION PER CHILD 1 3.000000 47.2800 15.7600
Subtotal (Total Children Is Unduplicated) 1922 28455.50000 1155874.9100 40.6204
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Total 40456.750000 1752916.8400 43.3282
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Number of Children (Unduplicated) With at Least One Service 3452
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Center 10
Flag Claims Units Chgs Paid
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R 99 86.500000 3911.0400 0.0000
U 0 0.000000 0.0000 0.0000
B 6684 6084.500000 305973.1100 0.0000
P 20719 19378.750000 586754.4800 584040.6000
D 2 2.000000 162.6400 0.0000
S 38 36.000000 1622.8600 200.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
16831 14253.500000 826429.6700 0.0000
Other 837 615.500000 28063.0400 0.0000
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Total 45210 40456.750000 1752916.8400 584240.6000