Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 52
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 1907 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 3 3 5.433333 $0.0000 $0.0000
TCM -T1017TL TARGETED CASE MANAGEMENT 2 2 6.671429 $246.8400 $37.0000
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Subtotal (Total Children Is Unduplicated) 5 5 12.104762 $246.8400 $20.3900
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 1 1 0.744444 $36.1000 $48.5000
AUDE -92588 OTOACOUSTIC EMISSIONS (COMP) 1 1 1.000000 $25.5300 $25.5300
EXIT -EXIT EXIT ASSESSMENT 2 2 1.511111 $75.5600 $50.0000
OCTH -97003 OT EVAL BY LICENSED OT, INITIAL 3 3 2.111111 $107.7700 $51.0500
SCREEN-T1023 SCREENING 7 7 6.783497 $339.1800 $50.0000
SPCH -92521 EVAL OF SPEECH FLUENCY 2 2 2.000000 $102.1000 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 5 5 3.022222 $154.2800 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF
VOICE AND 1 1 1.000000 $51.0500 $51.0500
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Subtotal (Total Children Is Unduplicated) 19 22 18.172385 $891.5700 $49.0600
EI Services, Class # 03
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 2 2 2.300000 $115.0000 $50.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 21 24 47.741631 $2387.0900 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 1 1 1.066667 $26.6700 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 407 637 1534.422830 $76721.1300 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 1 1 0.533333 $13.3300 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 276 404 1059.238820 $52961.9700 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 159 214 600.477771 $30023.8600 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 373 472 1246.935715 $62346.7900 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 5 5 7.966666 $199.1700 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 21 27 218.176982 $10908.8700 $50.0000
INTR -T1013 INTERPRETER 2 2 30.057143 $1502.8600 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 13 20 132.599998 $9472.9400 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 3 3 5.028572 $287.6300 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 8 13 53.583332 $3828.0000 $71.4400
PHY -97110HM PT SESSION BY PT ASST 1 2 13.142857 $751.2500 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 37 53 299.857143 $21421.8100 $71.4400
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Subtotal (Total Children Is Unduplicated) 544 1880 5253.129460 $272968.3400 $51.9600
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Total 1907 5283.406607 $274106.7600 $51.8800
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Number of Children (Unduplicated) With at Least One Authorization 550