CMS/EIP Fiscal Report Center: 51
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
Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 2 3.000000 242.9400 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 4.000000 323.9200 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 5 9.500000 569.2400 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 3 5.000000 299.6000 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 1 1.500000 121.4700 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 6 8.500000 688.3300 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 3 5.000000 283.4300 56.6860
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 1 2.000000 121.4700 60.7350
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 1 1.000000 59.9200 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 10 11.500000 931.2700 80.9800
OCTH-97165-OT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 3 3.000000 174.3300 58.1100
Subtotal (Total Children Is Unduplicated) 27 57.000000 4035.9900 70.8068
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 1238.7800 1238.7800
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 1 1.000000 54.0000 54.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 130 475.750000 25690.5000 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 3 10.000000 563.6800 56.3680
EPIC-99601-Early Steps Professional Development Fee 67 374.000000 5610.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 280 1283.000000 15552.0000 12.1216
OCCT-97530-OT SESSION BY LICENSED OT 88 303.750000 23839.7900 78.4849
OCCT-97530GOGT-OT SESSION BY LICENSED OT 3 11.000000 809.1600 73.5600
OCCT-97530GT-OT SESSION BY LICENSED OT 2 4.000000 276.6800 69.1700
OCCT-97530HM-OT SESSION BY OT ASST 14 50.000000 2975.0300 59.5006
PHY-97110-PT SESSION BY LICENSED PT 53 194.000000 15389.8100 79.3289
PHY-97110GT-PT SESSION BY LICENSED PT 1 3.000000 222.6400 74.2133
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 110 461.500000 36770.3300 79.6757
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 4 10.000000 813.2000 81.3200
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 1 1.000000 81.3200 81.3200
Subtotal (Total Children Is Unduplicated) 344 3184.000000 129911.9200 40.8015
-----------------------------------------------------------------------------------------------------------------------
Total 3241.000000 133947.9100 41.3292
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 358
-----------------------------------------------------------------------------------------------------------------------
Center 51
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 1659 2620.500000 92309.4700 92309.4700
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 0 0.000000 0.0000 0.0000
616 620.500000 41638.4400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 2275 3241.000000 133947.9100 92309.4700