Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 53
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: 01-01-18 and 03-31-18 Date of Report: 05-05-18 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 1.366666 $0.0000 $0.0000
SCTT -SCTT SERVICE COORDINATOR TRAVEL 2 2 16.285714 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 5 5 17.652380 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 4 5 1.533333 $74.3700 $48.5000
AUDE -92557 COMP AUDIO THRESHOLD EVAL/SPCH RECO 4 4 1.516666 $32.6800 $21.5500
EXIT -EXIT EXIT ASSESSMENT 7 7 4.505555 $225.2800 $50.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 9 9 3.550000 $266.2500 $75.0000
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 20 21 19.864285 $1489.8200 $75.0000
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 2 2 0.816667 $61.2500 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 11 11 4.805556 $360.4200 $75.0000
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 21 21 11.222221 $622.8300 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 1 1 0.500000 $37.5000 $75.0000
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Subtotal (Total Children Is Unduplicated) 46 81 48.314283 $3170.3900 $65.6200
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 2 2 1.177778 $5889.0000 $5000.0900
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 2 3 3.012698 $150.6300 $50.0000
AUDE -V5160 DISPENSING FEE BINAURAL 1 1 0.500000 $115.0000 $230.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 29 29 19.465079 $973.2600 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 2 2 1.150000 $28.7500 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 208 317 460.484123 $23024.1800 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 6 6 3.088888 $77.2200 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 6 6 3.027778 $151.3900 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 6 6 7.044445 $352.2300 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 1 1 0.333333 $8.3300 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 6 6 3.472222 $173.6100 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 1 1 0.133333 $3.3300 $24.9900
COUN -H2019HR INDIVIDUAL/FAMILY THERAPY 1 1 0.500000 $36.6600 $73.3200
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 1 2 2.677778 $66.9500 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 54 64 378.233336 $18911.6400 $50.0000
INTR -T1013 INTERPRETER 1 1 8.266667 $413.3400 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 776 1372 6571.134153 $65711.2700 $10.0000
SENS -HA_INS SENSORY AID INSURANCE PER EAR 1 1 0.500000 $32.5000 $65.0000
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Subtotal (Total Children Is Unduplicated) 779 1821 7464.201611 $116119.2700 $15.5600
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Total 1907 7530.168274 $119289.6600 $15.8400
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Number of Children (Unduplicated) With at Least One Authorization 783