CMS/EIP Fiscal Report Center: 55
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
Agency Filter:EXT
Payclass Filters:GR
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
EXIT-EXIT-COS Exit 2 3.000000 150.0000 50.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 3 6.000000 359.5200 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 12 24.000000 1943.5200 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 15 32.000000 2591.3600 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 28 56.000000 4534.8800 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 9 18.000000 1078.5600 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
OCTF-97168-OT RE-EVAL EST PLAN CARE 4 3.813973 221.6300 58.1100
OCTH-97167-OT EVAL HIGH COMPLEXITY 2 2.000000 116.2200 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 2 2.000000 116.2200 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 58.1100 58.1100
Subtotal (Total Children Is Unduplicated) 65 149.813973 11289.8600 75.3592
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 5 6.000000 300.0000 50.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 45 44.000000 2200.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 6 6.000000 300.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 47 32.250000 806.2500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 18 42.000000 2100.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 25 61.000000 1525.0000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 44 43.000000 2150.0000 50.0000
CONSF-CONSFGT-CONSULT, SLP, TELEMEDICINE 5 5.000000 250.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 44 28.250000 706.2500 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 132 688.191111 37162.3200 54.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 9 30.000000 1620.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 397 2180.000000 32700.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 299 1549.000000 18591.0000 12.0019
OCCT-97530-OT SESSION BY LICENSED OT 17 81.536522 6630.5500 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 26 139.510131 9084.9000 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 1 2.404791 156.6000 65.1200
PHY-97110-PT SESSION BY LICENSED PT 14 56.957206 4631.7600 81.3200
PHY-97110HM-PT SESSION BY PT ASST 12 51.595516 3359.9000 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 51 183.126046 14891.8100 81.3200
Subtotal (Total Children Is Unduplicated) 661 5229.821323 139166.3400 26.6102
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Total 5379.635296 150456.2000 27.9677
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Number of Children (Unduplicated) With at Least One Service 695
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Center 55
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 3089 3057.971955 86561.5500 86561.5500
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 1606 1599.206135 42850.3500 42850.3500
706 722.457206 21044.3000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 5401 5379.635296 150456.2000 129411.9000