Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 09
This report estimates subtotals of units and fees for the number of days of overlap between each included
FSPSA record and the user-selected report period. For example, if the FSPSA record authorizes services from
01/01/01 to 08/01/01, and the Report Period is selected as 01/01/01 to 03/01/01, this summary calculates
authorized units/fees for the 28 days of overlap (02/01/01 to 03/01/01). Note that service authorization periods
may range from 1 to 12 months and may vary in intensity from child to child.
FSPSAs overlapping: 10-01-11 and 12-31-11 Date of Report: 02-15-12 Page: 1
Eligibility Filter: Program Patients
Services Cpt Code Number of Number of Total Units Total Fees Avg Fee
Children Records Overlapping Overlapping Per Unit Auth
Report Period Report Period
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 3 3 3.000000 $4500.0000 $1500.0000
AUD -HA_FUP AUDIOLOGY SERVICES 7 9 9.000000 $450.0000 $50.0000
CONIF -CONIF CONSULT ITDS, FACE TO FACE 497 621 684.581749 $34229.1100 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 45 50 57.305557 $2865.2900 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 46 51 59.033334 $2951.6700 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 495 601 669.742860 $33487.1600 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 227 299 2134.147617 $106707.4600 $50.0000
HERN -T1027SC EI HEARING SERVICES AFTER SHINE 1 1 1.000000 $50.0000 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 24 28 213.428570 $14487.5300 $67.8800
PHY -97110 PT SESSION BY LICENSED PT 22 28 246.669048 $16743.9100 $67.8800
SCONLY-SCONLY SERVICE COORDINATION ONLY 20 21 21.585714 $21.5900 $1.0000
SENS -HA_INS SENSORY AID INSURANCE PER EAR 1 1 1.000000 $65.0000 $65.0000
SHIN -EIIF_NM INITIAL SHINE SERVICES, IND NONMED 1 1 1.000000 $50.0000 $50.0000
SHIN -T1027SC INITIAL SHINE SERVICES, INDIVIDUAL 12 17 29.142857 $1457.1500 $50.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 39 51 346.704762 $23534.3400 $67.8800
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Subtotal (Total Children Is Unduplicated) 676 1782 4477.342068 $241600.1900 $53.9600
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Total 1782 4477.342068 $241600.1900 $53.9600
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Number of Children (Unduplicated) With at Least One Authorization 676