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
Payclass Filters:GR
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 596 2518.750000 113612.4600 45.1067
Subtotal (Total Children Is Unduplicated) 837 3128.500000 134434.0800 42.9708
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 2 4.000000 200.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 7 14.000000 1093.2300 78.0879
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 5.000000 242.9400 48.5880
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 3.000000 242.9400 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 17 30.500000 1827.5600 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 5 9.000000 539.2800 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 1 1.500000 80.9800 53.9867
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 58 101.000000 8178.9800 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 19 32.500000 2631.8500 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 47 86.000000 6801.6400 79.0888
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 15 26.000000 2106.1600 81.0062
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 32 56.000000 4534.8800 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 13 21.000000 1700.5800 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 103 183.000000 10965.3600 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 79 135.500000 8119.1600 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 33 61.000000 4819.9400 79.0154
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 8 15.000000 1214.7000 80.9800
Subtotal (Total Children Is Unduplicated) 303 789.500000 55745.5700 70.6087
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 74 82.500000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 4 17.000000 918.0000 54.0000
EPIC-99601-Early Steps Professional Development Fee 94 140.000000 2139.0000 15.2786
INTR-T1013-INTERPRETER 38 65.250000 3343.6000 51.2429
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 63 75.000000 939.0000 12.5200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 1 2.000000 162.6400 81.3200
TRAV-TRAVS-Travel by mile 140 3396.000000 1508.2800 0.4441
Subtotal (Total Children Is Unduplicated) 258 3777.750000 9010.5200 2.3852
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Total 7695.750000 199190.1700 25.8831
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Number of Children (Unduplicated) With at Least One Service 1009
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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 43 278.750000 2135.1300 2135.1300
D 3 4.000000 200.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 7 10.750000 534.0500 537.5000
32 37.750000 2063.1400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 85 331.250000 4932.3200 2672.6300
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 50 931.000000 3382.0400 3382.0400
0 0.000000 0.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 50 931.000000 3382.0400 3382.0400
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
110 142.250000 8045.6900 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 110 142.250000 8045.6900 0.0000
Center 04
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
123 175.750000 8474.5600 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 123 175.750000 8474.5600 0.0000
Center 05
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 169 1235.000000 8729.8600 8729.8600
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
431 354.250000 10387.1800 712.8000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 601 1589.750000 19139.8800 9442.6600
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
196 131.750000 6338.6000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 197 133.750000 6498.6000 160.0000
Center 07
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 19 33.000000 739.4900 739.4900
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
357 292.750000 12573.2800 0.0000
Other 1 2.000000 161.9600 0.0000
---------------------------------------------------------
Total 377 327.750000 13474.7300 739.4900
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 145 457.750000 6886.7800 6886.7800
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 140 188.000000 8518.3800 8518.3800
49 257.750000 2954.7700 0.0000
Other 7 14.000000 923.1200 0.0000
---------------------------------------------------------
Total 341 917.500000 19283.0500 15405.1600
Center 10
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
479 561.250000 26872.9500 0.0000
Other 2 2.500000 114.2000 0.0000
---------------------------------------------------------
Total 481 563.750000 26987.1500 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
0 0.000000 0.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 43 69.000000 4251.6800 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 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 4 18.000000 491.2200 421.2200
182 182.750000 8492.6600 0.0000
Other 3 3.000000 137.0400 0.0000
---------------------------------------------------------
Total 189 203.750000 9120.9200 421.2200
Center 53
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 15 56.000000 691.8400 529.8800
298 424.750000 8155.5700 9.3000
Other 1 1.000000 80.9800 0.0000
---------------------------------------------------------
Total 314 481.750000 8928.3900 539.1800
Center 54
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 6 3.500000 159.8800 0.0000
S 7 5.500000 205.5600 0.0000
H 0 0.000000 0.0000 0.0000
T 34 170.000000 1336.7900 1336.7900
386 690.000000 20218.6100 0.0000
Other 1 2.000000 161.9600 161.9600
---------------------------------------------------------
Total 434 871.000000 22082.8000 1498.7500
Center 55
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 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
613 660.500000 29138.7200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 631 696.500000 31843.4000 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 0 0.000000 0.0000 0.0000
T 3 3.000000 45.0000 45.0000
153 258.000000 12699.9600 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 156 261.000000 12744.9600 45.0000