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
Agency Filter:EXT
Payclass Filters:TPIN
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
AUDE-92552-PURE TONE AUDIOMETRY -AIR ONLY 18 20.000000 386.2800 19.3140
AUDE-92555-SPEECH AUD THRESHOLD (DETECTION) 18 20.000000 290.7000 14.5350
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 19 19.000000 161.2100 8.4847
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 18 20.000000 572.5800 28.6290
AUDE-92588-OTOACOUSTIC EMISSIONS (COMP) 20 21.000000 478.8900 22.8043
AUDE-92650-AEP SCR AUDITORY POTENTIAL 1 1.000000 54.9000 54.9000
AUDE-92652-AEP THRSHLD EST MLT FREQ I&R 1 2.000000 141.4400 70.7200
AUDE-V5010-ASSESSMENT FOR HEARING AID 1 1.000000 45.3200 45.3200
AUDE-V5090-DISPENSING FEE PER HEARING AID 1 2.000000 231.6200 115.8100
EXIT-EXIT-COS Exit 2 3.000000 150.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 2 4.000000 323.9200 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 1.500000 121.4700 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 1 2.000000 119.8400 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 38 83.500000 6073.9900 72.7424
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 13 26.000000 2025.4800 77.9031
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 40 79.000000 6235.4600 78.9299
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 19 36.500000 2955.7700 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 16 31.500000 2550.8700 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 11 21.500000 1741.0700 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 70 134.500000 8059.2400 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 36 70.500000 4224.3600 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 14 27.000000 2186.4600 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 7 14.000000 1133.7200 80.9800
OCTF-97168-OT RE-EVAL EST PLAN CARE 7 6.186027 359.4700 58.1100
OCTH-97165-OT EVAL LOW COMPLEXITY 22 22.000000 1212.2200 55.1009
OCTH-97166-OT EVAL MODERATE COMPLEXITY 8 10.000000 464.8800 46.4880
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97167-OT EVAL HIGH COMPLEXITY 7 7.000000 406.7700 58.1100
PSTF-97164-PT RE-EVAL EST PLAN CARE 5 5.000000 290.5500 58.1100
PSTH-97161-PT EVAL LOW COMPLEXITY 14 14.000000 813.5400 58.1100
PSTH-97162-PT EVAL MODERATE COMPLEXITY 2 2.000000 116.2200 58.1100
PSTH-97163-PT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97163GT-PT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
SCREEN-T1023-SCREENING 3 3.000000 161.9400 53.9800
SPCH-92521-EVAL OF SPEECH FLUENCY 19 21.000000 1171.8500 55.8024
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 19 19.000000 1104.0900 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 49 243.000000 13795.4300 56.7713
Subtotal (Total Children Is Unduplicated) 391 1001.686027 60821.7600 60.7194
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 4035.3000 4035.3000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 1 1.000000 50.0000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1 1.000000 50.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 1 1.000000 50.0000 50.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 1 2.000000 54.0000 27.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 633 3004.750000 161153.7000 53.6330
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 59 159.250000 8599.5000 54.0000
EPIC-99601-Early Steps Professional Development Fee 1 1.000000 15.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 3 4.000000 48.0000 12.0000
OCCT-97530-OT SESSION BY LICENSED OT 295 1287.963479 100201.4300 77.7983
OCCT-97530GO-OT SESSION BY LICENSED OT 26 91.500000 7359.4600 80.4313
OCCT-97530GOGT-OT SESSION BY LICENSED OT 3 5.000000 406.6000 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 3 10.000000 813.2000 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 57 290.489869 17582.3300 60.5265
OCCT-97530HMGT-OT SESSION BY OT ASST 4 10.845209 706.2400 65.1200
PHY-97110-PT SESSION BY LICENSED PT 379 1629.542794 128390.7800 78.7894
PHY-97110GP-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 9 9.250000 752.2100 81.3200
PHY-97110HM-PT SESSION BY PT ASST 43 201.404484 12857.1200 63.8373
PHY-97110HMGT-PT SESSION BY PT ASST 6 14.000000 911.6800 65.1200
SENS-V5050-IN EAR MONAURAL HEARING AID 1 2.000000 459.2200 229.6100
SENS-V5264-EARMOLD 2 4.000000 72.5200 18.1300
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 606 2746.623954 217095.6620 79.0409
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 21 69.750000 5585.4500 80.0781
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 12 64.250000 4118.8400 64.1065
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 2 5.000000 325.6000 65.1200
SPL-92508HA-GROUP SPL SESSION PER CHILD 1 3.000000 47.2800 15.7600
Subtotal (Total Children Is Unduplicated) 1723 9620.619789 671822.4420 69.8315
-----------------------------------------------------------------------------------------------------------------------
Total 10622.305816 732644.2020 68.9722
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Number of Children (Unduplicated) With at Least One Service 1972
-----------------------------------------------------------------------------------------------------------------------
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 2284 2326.750000 137962.4020 137962.4000
D 74 73.750000 4760.9300 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 440 446.500000 25575.5500 25346.2600
0 0.000000 0.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 2798 2847.000000 168298.8820 163308.6600
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 208 180.500000 17067.8800 17067.8600
6 6.000000 414.3400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 214 186.500000 17482.2200 17067.8600
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
71 74.000000 5215.2700 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 71 74.000000 5215.2700 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 4 4.000000 121.7400 121.7400
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
1 1.000000 58.1100 0.0000
Other 22 22.000000 1555.2300 0.0000
---------------------------------------------------------
Total 27 27.000000 1735.0800 121.7400
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 297 265.750000 18357.3200 18357.3200
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
9 9.000000 681.3500 681.3500
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 306 274.750000 19038.6700 19038.6700
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 102 100.000000 6967.0200 6967.0200
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
225 219.250000 14103.9500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 327 319.250000 21070.9700 6967.0200
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 536 552.250000 41087.4400 41087.4400
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 536 552.250000 41087.4400 41087.4400
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 636 673.750000 52309.5300 52309.5300
D 7 7.000000 569.2400 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 396 383.250000 30071.1800 30071.1800
104 112.000000 8986.2300 0.0000
Other 25 49.500000 3587.3100 0.0000
---------------------------------------------------------
Total 1168 1225.500000 95523.4900 82380.7100
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 3023 2041.250000 147545.9800 147545.9800
D 0 0.000000 0.0000 0.0000
S 5 5.000000 341.8000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
1649 981.250000 72279.2000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 4677 3027.500000 220166.9800 147545.9800
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 7 7.000000 378.0000 378.0000
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
2 2.000000 162.6400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 9 9.000000 540.6400 378.0000
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 441 476.500000 28164.3500 28164.3500
149 178.250000 13151.0800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 590 654.750000 41315.4300 28164.3500
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 7 7.000000 514.6000 514.6000
107 113.000000 8746.9400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 114 120.000000 9261.5400 514.6000
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 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 133 133.810000 8497.4700 8497.4700
345 348.690000 22717.1300 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 478 482.500000 31214.6000 8497.4700
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 187 185.250000 14462.1800 14462.1800
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 141 138.750000 10263.8400 10263.8400
345 301.805815 23150.3500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 673 625.805815 47876.3700 24726.0200
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 11 8.329440 677.3500 677.3500
D 3 3.000000 243.9600 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 38 38.000000 2610.9600 2610.9600
151 147.170561 9284.3500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 203 196.500001 12816.6200 3288.3100