Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 04
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 6440 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 69 86 51.925394 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 69 86 51.925394 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 11 15 4.750000 $230.3800 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 2 2 2.000000 $112.9800 $56.4900
OCTH -97166 OT EVAL MODERATE COMPLEXITY 1 1 0.194444 $9.9200 $51.0400
OCTH -97167 OT EVAL HIGH COMPLEXITY 262 338 132.682527 $6773.3700 $51.0500
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 0.511111 $26.0900 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 1 1 0.511111 $26.0900 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 226 312 137.199202 $7004.0100 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 1 1 0.066667 $3.4100 $51.0700
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 111 129 64.780157 $3307.0200 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 2 2 0.527778 $26.9400 $51.0500
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 27 29 8.449999 $413.5400 $48.9400
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Subtotal (Total Children Is Unduplicated) 490 831 351.672996 $17933.7500 $51.0000
EI Services, Class # 03
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 1 2 2.000000 $100.0000 $50.0000
AUD -92633 AUD REHAB POSTLING HEARING LOSS 1 1 1.000000 $71.6100 $71.6100
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 47 124 48.495236 $2424.7500 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 6 6 13.530158 $676.5100 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 2 3 1.244444 $62.2200 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 6 7 6.392063 $319.6000 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 1 1 1.022222 $51.1100 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 1 2 2.433334 $60.8400 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 219 370 2387.142847 $59678.6800 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1412 1884 16962.653922 $848133.5700 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1409 2012 17789.338857 $177893.5500 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 138 146 1160.071425 $82875.6200 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 194 288 1621.246032 $92735.3200 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 127 148 1112.223017 $79457.2700 $71.4400
PHY -97110HM PT SESSION BY PT ASST 174 247 1545.500013 $88340.8400 $57.1600
SENS -V5060 BEHIND EAR HEARING AID 1 1 1.000000 $228.0000 $228.0000
SENS -V5264 EARMOLD 1 1 1.000000 $18.0000 $18.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 41 45 318.357143 $22743.4300 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 147 235 1193.571440 $16566.7700 $13.8800
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Subtotal (Total Children Is Unduplicated) 1724 5523 44168.222153 $1472437.6600 $33.3400
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Total 6440 44571.820543 $1490371.4100 $33.4400
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Number of Children (Unduplicated) With at Least One Authorization 1776