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
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 698 559.000000 24017.2500 42.9647
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 83 70.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 722 1785.750000 80376.9800 45.0102
Subtotal (Total Children Is Unduplicated) 1163 2414.750000 104394.2300 43.2319
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 15 17.000000 824.5000 48.5000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
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 3 6.000000 485.8800 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 3 6.000000 485.8800 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 12 25.500000 2064.9900 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 7 14.000000 1133.7200 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 1 1.500000 121.4700 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 2 4.000000 323.9200 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 1 1.000000 59.9200 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 9 18.000000 1078.5600 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 5 10.000000 809.8000 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 4 8.000000 539.8800 67.4850
Subtotal (Total Children Is Unduplicated) 61 117.000000 8321.3200 71.1224
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 2.000000 148.8000 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 1322.500000 30.0000 0.0227
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 2 2.000000 54.0000 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 14 60.000000 3201.0000 53.3500
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 5 5.000000 270.0000 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 20 57.000000 4635.2400 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 24 92.000000 7481.4400 81.3200
OCCT-97530GOGT-OT SESSION BY LICENSED OT 3 5.000000 406.6000 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 3 5.000000 406.6000 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 8 18.500000 1204.7200 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 2 2.000000 130.2400 65.1200
OCCT-97530TLGO-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
OCCT-97530TLGOGT-OT SESSION BY LICENSED OT 1 1.000000 81.3200 81.3200
PHY-97110-PT SESSION BY LICENSED PT 14 44.000000 3578.0800 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110TL-PT SESSION BY LICENSED PT 2 3.000000 243.9600 81.3200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 20 31.000000 2520.9200 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 2 2.000000 162.6400 81.3200
Subtotal (Total Children Is Unduplicated) 608 3457.500000 64372.9500 18.6184
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Total 5989.250000 177088.5000 29.5677
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Number of Children (Unduplicated) With at Least One Service 1327
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Center 54
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 0 0.000000 0.0000 0.0000
D 72 66.250000 3467.4200 0.0000
S 47 17.500000 666.3200 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
7660 5889.750000 172237.4200 0.0000
Other 34 15.750000 717.3400 0.0000
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Total 7813 5989.250000 177088.5000 0.0000