Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 01
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: 10-01-18 and 12-31-18 Date of Report: 02-05-19 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 8843 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 134 147 311.021427 $0.0000 $0.0000
TCM -T1017TL TARGETED CASE MANAGEMENT 1 1 0.788889 $29.1900 $37.0000
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Subtotal (Total Children Is Unduplicated) 135 148 311.810316 $29.1900 $0.0900
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 55 65 45.674279 $2215.2200 $48.5000
AUDE -92585 AUD EVOKED RESPONSE (COMP) 1 1 4.000000 $339.3600 $84.8400
EXIT -EXIT EXIT ASSESSMENT 202 206 409.500000 $20475.0000 $50.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 1 1 1.500000 $112.5000 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 1 1 1.500000 $112.5000 $75.0000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 10 10 19.000000 $1425.0000 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 21 21 36.500000 $2025.7500 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 18 20 32.500000 $2437.5000 $75.0000
OCTH -97167 OT EVAL HIGH COMPLEXITY 2 2 2.000000 $102.1000 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 1 1 1.000000 $51.0500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 1 1 2.000000 $102.1000 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 1 1 1.000000 $51.0500 $51.0500
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Subtotal (Total Children Is Unduplicated) 285 330 556.174279 $29449.1300 $52.9500
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 15 18 44.475343 $222377.0000 $5000.0100
AUD -92592TS AUDIOLOGY SERVICES (Monaural) 1 1 0.855556 $42.7800 $50.0000
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 23 25 14.433334 $721.6700 $50.0000
AUDE -V5160 DISPENSING FEE BINAURAL 2 2 2.044444 $470.2100 $230.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 242 268 279.319710 $13966.0000 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 7 8 12.800000 $320.0000 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 242 309 729.713145 $36485.7600 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 4 4 4.600000 $115.0000 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 59 72 164.749214 $8237.5000 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 3 3 7.966667 $199.1700 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 124 154 315.223024 $15761.1900 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 1 1 1.766667 $44.1700 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 189 229 470.207566 $23510.4800 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 7 8 11.900001 $297.5000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 116 130 992.242854 $49612.2300 $50.0000
INTR -T1013 INTERPRETER 155 177 689.322864 $34466.1900 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1942 3289 22864.861575 $228648.8400 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 11 15 101.000002 $7215.4400 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 14 15 97.690475 $6979.0200 $71.4400
PHY -97110HM PT SESSION BY PT ASST 1 1 3.714286 $212.3100 $57.1600
RSPT -RSPT RESPITE 1 1 3.571429 $0.0000 $0.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 45 52 439.823808 $31421.0600 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 1 1 7.571429 $105.0900 $13.8800
TRAV -TRAVS Travel by mile 2010 3582 23598.590502 $10501.4000 $0.4500
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Subtotal (Total Children Is Unduplicated) 2039 8365 50858.443895 $691709.9900 $13.6000
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Total 8843 51726.428490 $721188.3000 $13.9400
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Number of Children (Unduplicated) With at Least One Authorization 2129