Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 05
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: 10-01-16 and 12-31-16 Date of Report: 02-04-17 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 3875 FSPSA's found
Services Cpt Code Number of Number of Total Units Total Fees Avg Fee
Children Records Overlapping Overlapping Per Unit Auth
Report Period Report Period
Service Coordination, Class # 01
SCONLY-SCONLY *SERVICE COORDINATION ONLY 15 15 36.380953 $0.0000 $0.0000
TCM -T1017TL TARGETED CASE MANAGEMENT 1 1 1.066667 $39.4700 $37.0000
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Subtotal (Total Children Is Unduplicated) 16 16 37.447620 $39.4700 $1.0500
Screening, Eval, and Assessment, Class # 02
EVAL -96111 DEVELOPMENTAL EVALUATION 5 5 4.038356 $201.9200 $50.0000
EXIT -EXIT EXIT ASSESSMENT 92 100 100.851915 $5042.6100 $50.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 2 2 9.785714 $733.9300 $75.0000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 7 7 3.763698 $282.2800 $75.0000
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 2 2 1.700000 $127.5000 $75.0000
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 6 6 3.074887 $230.6100 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 25 25 23.263146 $1291.1000 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 2 2 3.666666 $275.0000 $75.0000
OCTF -97004 OT EVAL BY LICENSED OT, FOLLOW-UP 1 1 0.090411 $4.6100 $51.0400
OCTH -97003 OT EVAL BY LICENSED OT, INITIAL 101 103 27.564391 $1407.2200 $51.0500
PSTH -97001 EVAL BY LICENSED PT, INITIAL 51 52 19.375344 $989.1300 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 152 160 53.792461 $2746.1800 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF
VOICE AND 21 21 22.388652 $1142.9500 $51.0500
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Subtotal (Total Children Is Unduplicated) 355 486 273.355641 $14475.0500 $52.9500
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 9 9 4.912481 $24562.5000 $5000.0200
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 58 86 81.167454 $4058.3500 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 2 2 3.588889 $89.7200 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 557 756 1233.080288 $61654.0400 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 4 6 7.550794 $188.7700 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 127 158 259.411754 $12970.5900 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 210 268 410.697000 $20534.8500 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 385 478 707.821183 $35391.0900 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 6 7 12.133334 $303.3400 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 48 66 362.728576 $9068.2200 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 575 738 5322.646452 $266132.4800 $50.0000
INTR -T1013 INTERPRETER 14 21 181.071430 $9053.5600 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 116 144 995.737050 $71135.4600 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 13 13 84.709525 $4845.3800 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 138 168 1147.391674 $81969.7100 $71.4400
PHY -97110HM PT SESSION BY PT ASST 12 13 103.793673 $5932.8500 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 303 375 2795.565693 $199715.3100 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 24 24 188.428571 $2615.3900 $13.8800
TRAV -TRAVS Travel by mile 37 41 10463.528573 $4656.2700 $0.4500
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Subtotal (Total Children Is Unduplicated) 685 3373 24365.964394 $814877.8800 $33.4400
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Total 3875 24676.767655 $829392.3900 $33.6100
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Number of Children (Unduplicated) With at Least One Authorization 735