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: 10-01-17 and 12-31-17 Date of Report: 02-03-18 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 4859 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 17 17 23.004762 $0.0000 $0.0000
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 17 17 23.004762 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 1 1 1.000000 $48.5000 $48.5000
BEHV -BEHV BEHAVIORAL ASSESSMENT 1 1 5.428571 $678.5800 $125.0000
EVAL -96111 DEVELOPMENTAL EVALUATION 5 5 5.073973 $253.7000 $50.0000
EXIT -EXIT EXIT ASSESSMENT 112 131 125.875798 $6293.8100 $50.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 3 3 0.009590 $0.7100 $74.3000
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 5 5 2.017808 $151.3400 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 2 2 0.008220 $0.6200 $74.8200
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 3 3 3.001370 $166.5800 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 50 50 2.202745 $165.1700 $74.9800
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 5 5 4.015068 $301.1300 $75.0000
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 49 49 14.276719 $1070.7000 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 69 69 12.223300 $678.3300 $55.4900
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 31 31 2.104115 $157.7600 $74.9700
OCTH -97166 OT EVAL MODERATE COMPLEXITY 32 34 12.726029 $649.6700 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 89 92 35.075575 $1790.6400 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 2 2 0.504110 $25.7400 $51.0600
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 0.134247 $6.8500 $51.0300
PSTH -97162 PT EVAL MODERATE COMPLEXITY 12 13 5.602740 $286.0200 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 85 86 30.123228 $1537.8200 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 2 2 0.076712 $3.9200 $51.0400
SPCH -92522 EVAL OF SPCH SOUND PROD 2 2 0.441096 $22.5200 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 169 176 81.546243 $4163.0100 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF
VOICE AND 54 54 20.433715 $1043.1500 $51.0500
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 518 817 363.900972 $19496.2600 $53.5800
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 37 40 32.431095 $162156.5000 $5000.0300
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 23 24 39.400795 $1970.0400 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 1 1 1.022222 $25.5600 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 662 861 2200.050872 $110002.6000 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 5 6 7.180519 $179.5200 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 186 219 323.295142 $16164.7900 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 4.033333 $100.8300 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 297 364 637.334849 $31866.8200 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 511 659 1072.460741 $53623.1000 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 3 3 4.700000 $117.5000 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 99 144 941.119058 $23527.9900 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 623 804 5817.071442 $290853.9000 $50.0000
INTR -T1013 INTERPRETER 18 24 237.099999 $11854.9900 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 138 171 1236.425542 $88330.2700 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 9 9 63.714287 $3644.4600 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 192 229 1794.006359 $128163.8600 $71.4400
PHY -97110HM PT SESSION BY PT ASST 9 9 69.161904 $3953.3000 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 340 429 3252.173818 $232335.4500 $71.4400
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 1 1 0.785714 $44.9400 $57.2000
SPL -92508 GROUP SPL SESSION PER CHILD 20 21 201.209524 $2792.7900 $13.8800
TRAV -TRAVS Travel by mile 4 5 103.285714 $45.9600 $0.4500
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 809 4025 18037.962929 $1161755.1500 $64.4100
-------------------------------------------------------------------------------------------------------------------------------------
Total 4859 18424.868663 $1181251.4100 $64.1100
-------------------------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Authorization 865