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 2934 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
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Subtotal (Total Children Is Unduplicated) 17 17 23.004762 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
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 1 1 0.004110 $0.3100 $74.8200
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 3 3 2.010958 $150.8300 $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 34 34 2.134253 $160.0400 $74.9900
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 3 3 0.015068 $1.1300 $75.1600
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 28 28 6.716442 $503.7100 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 41 41 8.131513 $451.2600 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 10 10 0.043836 $3.2900 $74.9400
OCTH -97167 OT EVAL HIGH COMPLEXITY 8 8 4.608219 $235.2500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 3 3 2.005479 $102.3800 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 12 12 6.964384 $355.5400 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF
VOICE AND 2 2 0.158904 $8.1100 $51.0500
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Subtotal (Total Children Is Unduplicated) 213 287 172.181098 $9365.1300 $54.3900
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 3 3 3.000000 $15000.0000 $5000.0000
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 297 363 629.477706 $31473.9600 $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 58 80 557.557146 $13938.9500 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 230 297 2062.315877 $103115.9100 $50.0000
INTR -T1013 INTERPRETER 18 24 237.099999 $11854.9900 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 12 12 80.607142 $5758.5800 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 14 15 123.961903 $8855.8500 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 47 54 437.499999 $31255.0100 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 2 2 16.209524 $224.9900 $13.8800
TRAV -TRAVS Travel by mile 4 5 103.285714 $45.9600 $0.4500
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Subtotal (Total Children Is Unduplicated) 743 2630 7903.158634 $403708.1200 $51.0800
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Total 2934 8098.344494 $413073.2400 $51.0100
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Number of Children (Unduplicated) With at Least One Authorization 784