Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 04
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: 10-01-17 and 12-31-17 Date of Report: 02-03-18 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 6151 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 19 20 11.361110 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 19 20 11.361110 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 19 22 19.298555 $935.9900 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 4 4 11.287302 $579.6000 $51.3500
OCTF -97168 OT RE-EVAL EST PLAN CARE 2 2 1.022222 $52.1800 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 297 366 164.596819 $8402.6400 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 2 2 0.516666 $26.3700 $51.0400
PSTH -97001 EVAL BY LICENSED PT, INITIAL 1 1 0.266667 $13.6200 $51.0600
PSTH -97163 PT EVAL HIGH COMPLEXITY 247 312 133.446029 $6812.4200 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 173 214 66.566663 $3398.2100 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF
VOICE AND 3 3 0.966667 $49.3500 $51.0500
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Subtotal (Total Children Is Unduplicated) 564 926 397.967590 $20270.3700 $50.9300
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 1 1 3.066667 $15333.5000 $5000.0500
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 2 2 1.222222 $61.1100 $50.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 48 136 34.266669 $1713.3500 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 30 30 31.733331 $1586.6600 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 23 26 18.966665 $948.3300 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 9 9 9.522221 $476.1100 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 18 18 15.211109 $760.5500 $50.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 157 229 1590.142860 $39753.6200 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1358 1789 16974.633267 $848732.4300 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1315 1838 17016.772156 $170167.8700 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 347 444 3147.469057 $224855.3100 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 2 2 16.714285 $956.0600 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 282 369 2637.434917 $188418.5700 $71.4400
PHY -97110HM PT SESSION BY PT ASST 3 3 16.857144 $963.5500 $57.1600
SENS -V5140 BEHIND EAR BINAURAL HEARING AID
2 2 1.222222 $557.3200 $455.9900
SENS -V5264 EARMOLD 2 2 1.422222 $25.6000 $18.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 232 302 1818.319850 $129900.8100 $71.4400
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 1 1 4.571429 $261.4800 $57.2000
SPL -92508 GROUP SPL SESSION PER CHILD 2 2 21.857143 $303.3800 $13.8800
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Subtotal (Total Children Is Unduplicated) 1698 5205 43361.405436 $1625775.5800 $37.4900
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Total 6151 43770.734136 $1646045.9500 $37.6100
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Number of Children (Unduplicated) With at Least One Authorization 1712