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:EIP DEI DEIP
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 9014 26974.00000 1220727.6600 45.2557
Subtotal (Total Children Is Unduplicated) 9014 26974.00000 1220727.6600 45.2557
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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 60 109.000000 8826.8200 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 24 38.000000 3077.2400 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 55 96.000000 5752.3200 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 24 35.000000 2097.2000 59.9200
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 16 33.000000 2672.3400 80.9800
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 4 6.500000 526.3700 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 501 907.000000 73367.8800 80.8907
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 233 347.000000 28100.0600 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 295 512.500000 41436.5800 80.8519
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 159 252.500000 20447.4500 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 161 276.000000 22329.4200 80.9037
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 78 136.500000 11053.7700 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 570 1005.000000 60209.1000 59.9096
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 306 472.000000 28282.2400 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 128 221.000000 17852.8000 80.7819
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 71 111.000000 8988.7800 80.9800
OCTH-97165-OT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97166-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97161TL-PT EVAL LOW COMPLEXITY 1 1.000000 58.1100 58.1100
PSTH-97163TL-PT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
SCREEN-T1023-SCREENING 15 15.000000 809.7000 53.9800
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 58.1100 58.1100
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 2.000000 116.2200 58.1100
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 1 1.000000 58.1100 58.1100
SPL-92526TL-TREATMENT OF SWALLOWING DYSFUNCTION 6 31.000000 1801.4100 58.1100
Subtotal (Total Children Is Unduplicated) 1621 4675.000000 343231.5400 73.4185
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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 6 9.000000 243.0000 27.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 336 1355.500000 73291.4600 54.0697
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 25 40.000000 2160.0000 54.0000
OCCT-97530-OT SESSION BY LICENSED OT 11 11.000000 894.5200 81.3200
OCCT-97530GO-OT SESSION BY LICENSED OT 2 2.000000 162.6400 81.3200
OCCT-97530GT-OT SESSION BY LICENSED OT 1 2.000000 162.6400 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 1 1.000000 65.1200 65.1200
OCCT-97530TL-OT SESSION BY LICENSED OT 3 3.000000 243.9600 81.3200
OCCT-97530TLGO-OT SESSION BY LICENSED OT 121 398.250000 32385.6900 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 8 8.000000 650.5600 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110HM-PT SESSION BY PT ASST 1 1.500000 97.6800 65.1200
PHY-97110TL-PT SESSION BY LICENSED PT 109 419.750000 34134.0700 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 2 7.000000 455.8400 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 28 50.500000 4106.6600 81.3200
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 5 4.250000 345.6100 81.3200
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 107 358.750000 29173.5500 81.3200
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 18 29.750000 2326.9600 78.2171
Subtotal (Total Children Is Unduplicated) 684 2824.250000 189247.9600 67.0082
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Total 34473.250000 1753207.1600 50.8570
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Number of Children (Unduplicated) With at Least One Service 9393
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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 0 0.000000 0.0000 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
6 5.000000 299.0000 0.0000
Other 4 1.000000 45.6800 0.0000
---------------------------------------------------------
Total 925 874.750000 51079.6500 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 80 156.750000 7174.5800 0.0000
U 0 0.000000 0.0000 0.0000
B 832 1420.750000 67509.6000 0.0000
P 497 807.000000 40436.1500 38751.6900
D 10 19.250000 1008.5100 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
205 245.250000 17678.0300 0.0000
Other 1 1.000000 37.2000 0.0000
---------------------------------------------------------
Total 1625 2650.000000 133844.0700 38751.6900
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
5269 3852.750000 184473.1100 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 5272 3854.750000 184562.3500 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 0 0.000000 0.0000 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
846 959.750000 45282.9700 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 1925 2286.000000 111323.1700 66040.2000
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 98 85.750000 3876.7800 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 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
317 174.500000 7880.0000 0.0000
Other 793 578.500000 26372.8800 0.0000
---------------------------------------------------------
Total 7914 6961.750000 346816.6500 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
183 227.250000 11001.5500 0.0000
Other 52 39.500000 1798.0000 0.0000
---------------------------------------------------------
Total 1999 2083.750000 109642.3200 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
3 1.500000 104.1600 0.0000
Other 207 142.250000 6650.3700 349.1200
---------------------------------------------------------
Total 3086 2818.250000 163528.8600 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
1 0.250000 11.4200 0.0000
Other 288 195.000000 9097.0600 1226.0400
---------------------------------------------------------
Total 4020 3604.750000 189115.5300 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
128 116.000000 5298.8800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3007 2736.750000 134380.2700 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
102 159.250000 8123.8400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 1881 3002.250000 151244.6300 143120.7900