CMS/EIP Fiscal Report Center: 54
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 698 559.000000 24017.2500 42.9647
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 83 70.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1530 4418.500000 198750.4600 44.9814
Subtotal (Total Children Is Unduplicated) 1598 5047.500000 222767.7100 44.1343
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Screening, Eval, and Assessment,Class #02
AACIS-92597-AAC INTIAL EVAL BY LICENSED SLP 1 1.000000 116.8300 116.8300
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 15 17.000000 824.5000 48.5000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 4 8.000000 647.8400 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 2 3.000000 179.7600 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 3 6.000000 359.5200 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 2 4.000000 323.9200 80.9800
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
IPDEI-IPDEI_NM-INITIAL PSYCH & DEV EVAL BY NON-MED PR 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 6 11.000000 890.7800 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 8 16.000000 1295.6800 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 33 65.500000 5304.1900 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 21 42.000000 3401.1600 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 10 19.000000 1538.6200 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 12 25.000000 2024.5000 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 7 10.000000 599.2000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 24 46.000000 2756.3200 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 24 48.000000 3806.0600 79.2929
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 12 24.000000 1835.5600 76.4817
SCREEN-T1023-SCREENING 1 1.000000 53.9800 53.9800
Subtotal (Total Children Is Unduplicated) 177 352.500000 26393.3400 74.8747
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EI Services,Class #03
AACFIT-92609-AAC FITTING, ADJUST, TRAINING VISIT 1 1.000000 47.9400 47.9400
AACFIT-92609TL-AAC FITTING, ADJUST, TRAINING VISIT 1 1.000000 47.9400 47.9400
ASST-ASST-ASSISTIVE TECHNOLOGY 3 6.000000 446.4000 74.4000
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 19 18.750000 887.5000 47.3333
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 76 79.000000 3954.0000 50.0506
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 8 5.000000 250.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 103 40.000000 2045.5000 51.1375
CONOF-CONOF-CONSULT, OT, FACE TO FACE 6 3.750000 187.5000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 209 100.250000 5012.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 16 6.750000 168.7500 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 4 1.500000 75.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 137 58.750000 2937.5000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 9 5.500000 275.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 165 65.250000 3262.5000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 1 1.000000 25.0000 25.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 412 1323.000000 30.0000 0.0227
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 10 23.000000 621.0000 27.0000
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 1 1.000000 15.0000 15.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 95 327.500000 17753.9600 54.2106
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 14 21.000000 1134.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 349 1107.000000 16839.0000 15.2114
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 100 310.000000 3720.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 37 93.000000 7562.7600 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 37 124.000000 10083.6800 81.3200
OCCT-97530GOGT-OT SESSION BY LICENSED OT 5 9.000000 731.8800 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 4 6.000000 487.9200 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 21 84.500000 5502.6400 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 4 4.500000 293.0400 65.1200
OCCT-97530TL-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
OCCT-97530TLGO-OT SESSION BY LICENSED OT 60 200.000000 16264.0000 81.3200
OCCT-97530TLGOGT-OT SESSION BY LICENSED OT 4 4.000000 325.2800 81.3200
OCCT-97530TLGTHM-OT SESSION BY OT ASST 6 9.000000 586.0800 65.1200
OCCT-97530TLHM-OT SESSION BY OT ASST 17 73.000000 4753.7600 65.1200
PHY-97110-PT SESSION BY LICENSED PT 40 117.500000 9555.1000 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 3 2.000000 162.6400 81.3200
PHY-97110TL-PT SESSION BY LICENSED PT 50 184.750000 15023.8700 81.3200
PHY-97110TLGP-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110TLGPGT-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110TLGT-PT SESSION BY LICENSED PT 2 2.000000 162.6400 81.3200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 50 80.000000 6505.6000 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 6 6.000000 487.9200 81.3200
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 35 52.000000 4228.6400 81.3200
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 2 2.000000 162.6400 81.3200
Subtotal (Total Children Is Unduplicated) 613 4562.250000 142860.0400 31.3135
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Total 9962.250000 392021.0900 39.3507
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Number of Children (Unduplicated) With at Least One Service 1632
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Center 54
Flag Claims Units Chgs Paid
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R 79 73.250000 4100.7800 0.0000
U 0 0.000000 0.0000 0.0000
B 2087 1922.000000 100133.4600 0.0000
P 1266 1156.860000 63875.2700 63243.1900
D 298 267.390000 13516.5600 5907.6400
S 151 104.250000 4531.5400 0.0000
H 8 7.750000 532.2200 0.0000
T 0 0.000000 0.0000 0.0000
7977 6217.000000 195272.9000 0.0000
Other 325 213.750000 10058.3600 1226.0400
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Total 12191 9962.250000 392021.0900 70376.8700