Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 03
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: 07-01-19 and 09-30-19 Date of Report: 11-04-19 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 3224 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 175 185 160.435702 $0.0000 $0.0000
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 175 185 160.435702 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 58 75 55.037136 $2669.3000 $48.5000
AUDE -92579 VISUAL REINFORCEMENT AUDIOMETRY 2 2 2.000000 $55.6600 $27.8300
AUDE -V5090 DISPENSING FEE PER HEARING AID 1 1 0.126027 $14.4900 $114.9800
OCTH -97167 OT EVAL HIGH COMPLEXITY 7 9 3.520319 $179.7100 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 17 22 14.255251 $727.7300 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 24 30 15.586759 $795.7100 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 1 1 0.511111 $26.0900 $51.0500
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 98 140 91.036603 $4468.6900 $49.0900
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 14 17 11.901522 $59508.0000 $5000.0300
CONIF -CONIF CONSULT, ITDS FACE TO FACE 613 859 1409.298394 $70464.8300 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 299 392 581.438096 $29071.9100 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 246 345 545.618251 $27280.9000 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 600 825 1158.302356 $57914.9800 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 254 366 2272.252378 $113612.7400 $50.0000
INTR -T1013 INTERPRETER 5 6 46.336509 $2316.8300 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 9 11 72.199999 $5157.9800 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 24 35 226.317461 $16168.1700 $71.4400
SENS -V5050 IN EAR MONAURAL HEARING AID 1 1 0.126027 $28.7300 $227.9500
SENS -V5264 EARMOLD 1 1 0.126027 $2.2700 $18.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 31 41 291.176191 $20801.6300 $71.4400
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 809 2899 6615.093211 $402328.9500 $60.8200
-------------------------------------------------------------------------------------------------------------------------------------
Total 3224 6866.565516 $406797.6400 $59.2400
-------------------------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Authorization 968