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: 10-01-13 and 12-31-13 Date of Report: 02-18-14 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
AUD -HA_FUP AUDIOLOGY SERVICES 1 1 0.866667 $43.3400 $50.0000
CONIF -CONIF CONSULT ITDS, FACE TO FACE 1521 2040 3058.277617 $152913.0900 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 1519 2004 2991.795075 $149588.9600 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 1521 2021 3045.260952 $152262.2700 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 1522 2053 3076.666508 $153832.5500 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 284 393 2465.985704 $123299.4200 $50.0000
INTR -INTR INTERPRETER 1 1 6.285714 $314.2900 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 22 25 135.935712 $9227.3300 $67.8800
PHY -97110 PT SESSION BY LICENSED PT 22 28 141.268252 $9589.2900 $67.8800
SHIN -T1027SC INITIAL SHINE SERVICES, INDIVIDUAL 11 14 20.076189 $1003.8100 $50.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 40 52 366.493649 $24877.6200 $67.8800
TRAV -TRAV PROV TRAVEL TO NATURAL ENV PER MINU 107 384 45106.647619 $22553.3200 $0.5000
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Subtotal (Total Children Is Unduplicated) 1549 9016 60415.559658 $799505.2600 $13.2300
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Total 9016 60415.559658 $799505.2600 $13.2300
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Number of Children (Unduplicated) With at Least One Authorization 1549