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:MED
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
TCM-T1017TL-TARGETED CASE MANAGEMENT 9089 27122.00000 1227481.9400 45.2578
Subtotal (Total Children Is Unduplicated) 9089 27122.00000 1227481.9400 45.2578
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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
AACIS-92597TL-AAC INTIAL EVAL BY LICENSED SLP 2 2.000000 233.6600 116.8300
AUDE-92558-OTOACOUSTIC EMISSIONS (SCREENING) 1 1.000000 6.8700 6.8700
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 64 116.000000 9393.6800 80.9800
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 16 22.000000 1781.5600 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 25 40.000000 3239.2000 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 6 9.500000 769.3100 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 11 20.000000 1619.6000 80.9800
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 4 7.500000 607.3500 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 68 120.500000 7220.3600 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 28 42.500000 2546.6000 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 17 34.500000 2793.8100 80.9800
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 5 8.500000 688.3300 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 536 976.000000 78955.5000 80.8970
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 244 367.000000 29677.5400 80.8652
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 347 614.000000 49656.0500 80.8730
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 203 335.500000 27137.2000 80.8858
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 194 342.000000 27674.1000 80.9184
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 89 158.000000 12794.8400 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 685 1225.000000 73391.5000 59.9114
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 392 632.500000 37899.4000 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 144 248.500000 20079.7500 80.8038
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 85 138.500000 11296.7100 81.5647
OCTF-97168-OT RE-EVAL EST PLAN CARE 11 11.000000 639.2100 58.1100
OCTH-97165-OT EVAL LOW COMPLEXITY 18 18.000000 1045.9800 58.1100
OCTH-97166-OT EVAL MODERATE COMPLEXITY 11 11.000000 639.2100 58.1100
OCTH-97167-OT EVAL HIGH COMPLEXITY 10 10.000000 581.1000 58.1100
OCTH-97167TL-OT EVAL HIGH COMPLEXITY 4 4.000000 232.4400 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 4 4.000000 232.4400 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 15 15.000000 871.6500 58.1100
PSTH-97161TL-PT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97163-PT EVAL HIGH COMPLEXITY 2 2.000000 116.2200 58.1100
PSTH-97163TL-PT EVAL HIGH COMPLEXITY 2 2.000000 116.2200 58.1100
SCREEN-T1023-SCREENING 17 17.000000 917.6600 53.9800
SPCH-92521-EVAL OF SPEECH FLUENCY 15 16.000000 929.7600 58.1100
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 4 4.000000 232.4400 58.1100
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 2 3.000000 174.3300 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 22 138.000000 8019.1800 58.1100
SPL-92526TL-TREATMENT OF SWALLOWING DYSFUNCTION 9 34.000000 1975.7400 58.1100
Subtotal (Total Children Is Unduplicated) 1803 5752.000000 416361.4400 72.3855
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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
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 14 22.000000 594.0000 27.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 4772 28699.50000 1548880.4600 53.9689
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 513 1735.500000 93555.0000 53.9067
OCCT-97530-OT SESSION BY LICENSED OT 263 1167.750000 94880.1100 81.2504
OCCT-97530GO-OT SESSION BY LICENSED OT 14 26.000000 2114.3200 81.3200
OCCT-97530GOGT-OT SESSION BY LICENSED OT 2 5.000000 406.6000 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 7 14.000000 975.8400 69.7029
OCCT-97530HM-OT SESSION BY OT ASST 95 499.750000 32608.5200 65.2497
OCCT-97530HMGT-OT SESSION BY OT ASST 3 9.000000 586.0800 65.1200
OCCT-97530TL-OT SESSION BY LICENSED OT 4 9.000000 731.8800 81.3200
OCCT-97530TLGO-OT SESSION BY LICENSED OT 127 411.250000 33442.8500 81.3200
OCCT-97530TLGOGT-OT SESSION BY LICENSED OT 16 15.500000 1260.4600 81.3200
OCCT-97530TLGTHM-OT SESSION BY OT ASST 6 9.000000 586.0800 65.1200
OCCT-97530TLHM-OT SESSION BY OT ASST 22 89.000000 5795.6800 65.1200
PHY-97110-PT SESSION BY LICENSED PT 257 965.250000 78494.1300 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 2 2.000000 162.6400 81.3200
PHY-97110HM-PT SESSION BY PT ASST 68 329.750000 21473.3200 65.1200
PHY-97110HMGT-PT SESSION BY PT ASST 3 10.000000 651.2000 65.1200
PHY-97110TL-PT SESSION BY LICENSED PT 120 450.750000 36654.9900 81.3200
PHY-97110TLGP-PT SESSION BY LICENSED PT 2 2.000000 162.6400 81.3200
PHY-97110TLGPGT-PT SESSION BY LICENSED PT 2 2.000000 162.6400 81.3200
PHY-97110TLGT-PT SESSION BY LICENSED PT 3 2.500000 203.3000 81.3200
PHY-97110TLHM-PT SESSION BY PT ASST 9 43.000000 2800.1600 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 380 1704.500000 138609.9400 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 20 44.750000 3639.0700 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 19 91.000000 5925.9200 65.1200
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 125 407.500000 33137.9000 81.3200
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 19 31.750000 2489.6000 78.4126
Subtotal (Total Children Is Unduplicated) 5939 36801.00000 2141081.2100 58.1800
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Total 69675.000000 3784924.5900 54.3226
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Number of Children (Unduplicated) With at Least One Service 11110
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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 0 0.000000 0.0000 0.0000
D 139 150.750000 8594.0900 0.0000
S 291 208.000000 10940.0100 0.0000
H 624 660.750000 39794.9600 39794.9600
T 0 0.000000 0.0000 0.0000
7 6.000000 353.0000 0.0000
Other 4 1.000000 45.6800 0.0000
---------------------------------------------------------
Total 1065 1026.500000 59727.7400 39794.9600
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
961 625.000000 29538.9800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 961 625.000000 29538.9800 0.0000
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 103 181.250000 8293.7400 0.0000
U 0 0.000000 0.0000 0.0000
B 926 1522.000000 72134.7000 0.0000
P 513 825.750000 41412.0000 39425.4700
D 11 20.000000 1036.4100 0.0000
S 0 0.000000 0.0000 0.0000
H 4876 4875.750000 264754.7200 0.0000
T 0 0.000000 0.0000 0.0000
209 248.750000 17875.2000 0.0000
Other 2 2.000000 102.3200 0.0000
---------------------------------------------------------
Total 6640 7675.500000 405609.0900 39425.4700
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 1 0.250000 11.4200 0.0000
U 0 0.000000 0.0000 0.0000
B 2450 1226.000000 56001.5600 28053.9300
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
16 8.250000 376.8600 0.0000
Other 57 42.000000 1918.5600 0.0000
---------------------------------------------------------
Total 2524 1276.500000 58308.4000 28053.9300
Center 06
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 3 2.000000 89.2400 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
9124 7728.250000 393939.1100 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 9127 7730.250000 394028.3500 0.0000
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 62 48.500000 2215.4800 0.0000
U 0 0.000000 0.0000 0.0000
B 370 355.250000 19177.8400 0.0000
P 1343 1246.750000 66154.3000 64872.1800
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
18 12.250000 630.1800 0.0000
Other 50 36.000000 1644.4800 0.0000
---------------------------------------------------------
Total 1843 1698.750000 89822.2800 64872.1800
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 0 0.000000 0.0000 0.0000
D 11 11.000000 621.3200 0.0000
S 0 0.000000 0.0000 0.0000
H 1079 1326.250000 66040.2000 66040.2000
T 0 0.000000 0.0000 0.0000
5237 5408.750000 302349.6700 0.0000
Other 57 110.000000 7380.9500 0.0000
---------------------------------------------------------
Total 6384 6856.000000 376392.1400 66040.2000
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 99 86.500000 3911.0400 0.0000
U 0 0.000000 0.0000 0.0000
B 6684 6084.500000 305973.1100 0.0000
P 22 38.500000 2713.8800 0.0000
D 0 0.000000 0.0000 0.0000
S 13 11.500000 762.0600 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
10280 8916.000000 536605.4100 0.0000
Other 793 578.500000 26372.8800 0.0000
---------------------------------------------------------
Total 17891 15715.500000 876338.3800 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 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
613 617.500000 41394.8200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 613 617.500000 41394.8200 0.0000
Center 52
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 23 15.250000 746.5400 0.0000
U 0 0.000000 0.0000 0.0000
B 852 864.750000 44818.4200 0.0000
P 714 777.500000 44062.8300 43816.2700
D 0 0.000000 0.0000 0.0000
S 174 158.500000 7160.9800 0.0000
H 0 0.000000 0.0000 0.0000
T 1 1.000000 54.0000 15.0000
877 927.500000 52341.8600 0.0000
Other 52 39.500000 1798.0000 0.0000
---------------------------------------------------------
Total 2693 2784.000000 150982.6300 43831.2700
Center 53
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 139 117.750000 6258.5200 0.0000
U 0 0.000000 0.0000 0.0000
B 1607 1517.500000 88786.5600 37.2000
P 961 890.750000 53740.1300 53316.9300
D 123 104.000000 4905.4900 3640.0400
S 42 40.250000 2818.2100 0.0000
H 4 4.250000 265.4200 0.0000
T 0 0.000000 0.0000 0.0000
1269 1322.500000 74708.7500 0.0000
Other 207 142.250000 6650.3700 349.1200
---------------------------------------------------------
Total 4352 4139.250000 238133.4500 57343.2900
Center 54
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 1265 1156.000000 63804.5500 63172.4700
D 192 167.750000 7896.1000 5907.6400
S 104 86.750000 3865.2200 0.0000
H 4 3.750000 206.9400 0.0000
T 0 0.000000 0.0000 0.0000
1775 1860.250000 107826.6500 0.0000
Other 288 195.000000 9097.0600 1226.0400
---------------------------------------------------------
Total 5794 5464.750000 296930.7600 70306.1500
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 2879 2620.750000 129081.3900 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
2355 2411.500000 157624.3600 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 5234 5032.250000 286705.7500 0.0000
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 1779 2843.000000 143120.7900 143120.7900
T 0 0.000000 0.0000 0.0000
6123 6190.250000 337891.0300 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 7902 9033.250000 481011.8200 143120.7900