CMS/EIP Fiscal Report Statewide
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 479 475.750000 20821.6200 43.7659
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 135 134.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1167 5150.250000 232725.5400 45.1872
Subtotal (Total Children Is Unduplicated) 1186 5760.000000 253547.1600 44.0186
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Screening, Eval, and Assessment,Class #02
AUDE-92558-OTOACOUSTIC EMISSIONS (SCREENING) 1 1.000000 6.8700 6.8700
EXIT-EXIT-COS Exit 2 4.000000 200.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 26 48.000000 3846.5500 80.1365
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 3 6.500000 364.4100 56.0631
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 9 15.000000 1214.7000 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 3 6.000000 485.8800 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 4 8.500000 688.3300 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 28 52.000000 3115.8400 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 12 22.500000 1348.2000 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 6 9.500000 728.8200 76.7179
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 2 3.500000 283.4300 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 436 759.500000 61423.3300 80.8734
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 125 186.000000 15062.2800 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 242 413.000000 33282.1000 80.5862
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 120 195.000000 15710.8000 80.5682
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 151 277.000000 22107.5400 79.8106
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 47 83.500000 6761.8300 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 464 799.500000 47897.2000 59.9089
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 271 466.000000 27862.8000 59.7914
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 118 203.000000 16211.1400 79.8578
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 52 85.500000 6923.7900 80.9800
MED-99203-OUTPATIENT VISIT, NEW, 30 MINS 5 5.000000 768.6500 153.7300
Subtotal (Total Children Is Unduplicated) 1147 3649.500000 266294.4900 72.9674
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 75 83.500000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 6 28.000000 1512.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 94 140.000000 2139.0000 15.2786
INTR-T1013-INTERPRETER 38 66.250000 3393.6000 51.2242
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 63 75.000000 939.0000 12.5200
OCCT-97530HM-OT SESSION BY OT ASST 1 6.000000 390.7200 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 1 4.000000 325.2800 81.3200
TRAV-TRAVS-Travel by mile 140 3396.000000 1508.2800 0.4441
Subtotal (Total Children Is Unduplicated) 259 3798.750000 10207.8800 2.6872
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Total 13208.250000 530049.5300 40.1302
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Number of Children (Unduplicated) With at Least One Service 1421
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Center 01
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 59 304.250000 3853.2400 3853.2400
D 6 9.000000 499.6000 0.0000
S 53 50.500000 2649.9100 0.0000
H 128 183.750000 12936.3500 8927.9700
T 8 12.750000 653.8900 657.3400
35 41.250000 2293.9200 0.0000
Other 3 4.250000 247.0900 0.0000
---------------------------------------------------------
Total 292 605.750000 23134.0000 13438.5500
Center 02
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 0 0.000000 0.0000 0.0000
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 53 937.000000 3867.9200 3867.9200
0 0.000000 0.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 53 937.000000 3867.9200 3867.9200
Center 03
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 0 0.000000 0.0000 0.0000
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
168 220.000000 12481.3100 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 168 220.000000 12481.3100 0.0000
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 10 23.000000 1050.6400 0.0000
U 0 0.000000 0.0000 0.0000
B 67 121.250000 5767.2500 0.0000
P 30 50.500000 2715.4400 2584.4000
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
234 303.250000 18594.6400 0.0000
Other 1 2.500000 114.2000 0.0000
---------------------------------------------------------
Total 342 500.500000 28242.1700 2584.4000
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 297 230.750000 10540.6600 3768.2700
P 170 1237.000000 8891.8200 8891.8200
D 1 0.500000 22.8400 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
433 356.500000 10489.9600 712.8000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 901 1824.750000 29945.2800 13372.8900
Center 06
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 1 2.000000 160.0000 160.0000
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
411 347.750000 18930.1200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 412 349.750000 19090.1200 160.0000
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 3 2.250000 102.7800 0.0000
U 0 0.000000 0.0000 0.0000
B 20 31.500000 1934.3200 0.0000
P 166 221.250000 12031.2300 11825.9300
D 3 6.000000 485.8800 0.0000
S 0 0.000000 0.0000 0.0000
H 2 4.000000 323.9200 0.0000
T 0 0.000000 0.0000 0.0000
373 323.000000 14756.6200 0.0000
Other 11 15.750000 1030.3400 0.0000
---------------------------------------------------------
Total 578 603.750000 30665.0900 11825.9300
Center 09
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 190 539.750000 12664.3600 12664.3600
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 258 380.250000 22933.9200 8910.7300
T 176 247.500000 12620.6500 12620.6500
165 458.500000 15076.9200 0.0000
Other 43 80.000000 5407.6000 0.0000
---------------------------------------------------------
Total 832 1706.000000 68703.4500 34195.7400
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 18 21.250000 1099.4500 0.0000
U 0 0.000000 0.0000 0.0000
B 584 796.750000 45566.1000 0.0000
P 7 9.750000 717.5500 0.0000
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
666 882.000000 50651.4800 0.0000
Other 11 10.500000 479.6400 0.0000
---------------------------------------------------------
Total 1286 1720.250000 98514.2200 0.0000
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 43 69.000000 4251.6800 4251.6800
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
8 11.000000 890.7800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 51 80.000000 5142.4600 4251.6800
Center 52
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 51 80.250000 4231.8200 0.0000
P 44 71.750000 4187.2200 3967.7400
D 0 0.000000 0.0000 0.0000
S 41 37.500000 1710.8800 0.0000
H 2 4.000000 323.9200 0.0000
T 19 48.000000 2486.8600 2365.7000
211 234.250000 11693.5800 0.0000
Other 3 3.000000 137.0400 0.0000
---------------------------------------------------------
Total 371 478.750000 24771.3200 6333.4400
Center 53
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 2 2.250000 102.7800 0.0000
U 0 0.000000 0.0000 0.0000
B 107 138.250000 7979.5700 0.0000
P 36 50.250000 2523.4100 2489.4900
D 9 10.000000 520.8800 204.6000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 15 56.000000 691.8400 529.8800
328 474.500000 11666.0500 9.3000
Other 9 9.000000 495.8200 83.7000
---------------------------------------------------------
Total 506 740.250000 23980.3500 3316.9700
Center 54
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 5 8.250000 251.2400 0.0000
U 0 0.000000 0.0000 0.0000
B 213 274.750000 13905.3600 0.0000
P 128 158.750000 8245.6400 8082.8000
D 14 12.250000 559.5800 325.5000
S 32 29.750000 1296.3400 0.0000
H 0 0.000000 0.0000 0.0000
T 36 174.000000 1576.4700 1576.4700
441 791.500000 27511.4400 0.0000
Other 9 13.500000 687.2800 561.8600
---------------------------------------------------------
Total 878 1462.750000 54033.3500 10546.6300
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 203 427.500000 25111.4000 0.0000
P 16 32.000000 2380.7600 2380.7600
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 2 4.000000 323.9200 323.9200
699 838.500000 42905.3200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 920 1302.000000 70721.4000 2704.6800
Center 57
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 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 193 354.750000 20595.1900 20595.1900
T 3 3.000000 45.0000 45.0000
188 319.000000 16116.9000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 384 676.750000 36757.0900 20640.1900